Active NPI
William Vermont Stenberg, DDS
- Periodontics
- Phoenix, AZ
National Provider Identifier
1003979584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 30951
- Practice address
- 4212 N 16TH St
Phoenix, AZ 85016-5319 - Phone
- (602) 263-1200
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6965 | KS | |
| Periodontics | 1223P0300X | 30951 | CA | Primary |
Addresses
Primary practice location
4212 N 16TH St
Phoenix, AZ 85016-5319
Mailing address
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9330951 | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6965 | KS | MD | Dentist |
| 30951 | CA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Current | Accepting new patients | |
| Gila River Health Care Corporation | Current | Accepting new patients | |
| Gila River Health Care Corporation | Current | Accepting new patients | |
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Current | Accepting new patients | |
| Gila River Health Care Corporation | Current | Accepting new patients | |
| Gila River Health Care | Current | Accepting new patients |
Locations
17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000
48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881
4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health or Welfare Agency
- Phoenix, AZ
- NPI 1083643738
TX
-
- Public Health or Welfare Agency
- Maricopa, AZ
- NPI 1538043443
-
- Community/Behavioral Health Agency
- Laveen, AZ
- NPI 1598021495
-
- Rural Acute Care Hospital
- Maricopa, AZ
- NPI 1386633915
-
- Case Management Agency
- Chandler, AZ
- NPI 1629579230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747699200000",
"number": "1003979584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S BLISS AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744642512",
"telephone_number": "918-458-3100",
"fax_number": "918-458-3628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 N 16TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850165319",
"telephone_number": "602-263-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STENBERG",
"first_name": "WILLIAM",
"middle_name": "VERMONT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "6965",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "30951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9330951",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.