Stephen a. Rendulich, DDS, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7749 Issued in NC

Legal business name

STEPHEN A. RENDULICH, DDS, PA

Practice address

10210 Hickorywood Hill Ave
Suite 200
Huntersville, NC 28078-3332

Phone

(704) 875-8833

Fax

(704) 875-0303

NPI assigned

Aug 5, 2008

Organization subpart

No

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

Authorized official

Name

Lora Sigmon

Title

Office Administrator

Phone

(704) 875-8833

Specialties & licenses 1

Addresses

Other names 1

• The Center For Oral & Maxillofacial Surgery Doing business as

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1013173483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10210 HICKORYWOOD HILL AVE",
            "address_2": "SUITE 200",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783332",
            "telephone_number": "704-875-8833",
            "fax_number": "704-875-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10210 HICKORYWOOD HILL AVE",
            "address_2": "SUITE 200",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783332",
            "telephone_number": "704-875-8833",
            "fax_number": "704-875-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN A. RENDULICH, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "SIGMON",
        "authorized_official_first_name": "LORA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "704-875-8833"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "7749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center For Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephany L Steen, FNP-BC, FNP-C
• Regina V Stefic, P.A.
• Jackie Diane Stegall, OTRL
• Kevin Steinhaus, DC
• Beth E. Stephani
• Tiona Kimisha Stephens, M.D.
• Krista Stephenson
• Asha Garg Stern, MD
• Thomas P. Stern, M.D.
• Leah Stevens

• Oral and Maxillofacial Surgery (Dentist) in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.