Gary L. Stevens, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS025317L Issued in PA

Practice address

1030 E Willow Grove Ave
Wyndmoor, PA 19038-7938

Phone

(215) 233-1700

Fax

(215) 233-1730

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013099266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E WILLOW GROVE AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387938",
            "telephone_number": "215-233-1700",
            "fax_number": "215-233-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E WILLOW GROVE AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387938",
            "telephone_number": "215-233-1700",
            "fax_number": "215-233-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "GARY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS025317L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie L Skymba, CRNP
• Marissa Smale, MA, LPC, BCPC
• Springfield Township Ambulance Association
• Robert B. Staples, PSY.D.
• Raphael Hayim Star, LSW
• Jocelyn Villaruz Stevens, DDS
• Karen A Sullivan, MD
• Haley Sutton
• Tasker Healthcare Group PC
• Temple Physicians Inc

• General Practice Dentistry in Wyndmoor, PA
• Providers in Wyndmoor, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.