S. Steven Podstreleny, DDS, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

50861 Issued in CA

Legal business name

S. STEVEN PODSTRELENY, DDS, PC

Doing business as

Park Blvd Oral Surgery

Practice address

4067 Park Blvd
San Diego, CA 92103-2619

Phone

(619) 795-0154

Fax

(619) 795-0512

NPI assigned

Jul 27, 2010

Last updated

Jul 16, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

S. STEVEN PODSTRELENY, DDS P.C.As reported in NPPES

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

Authorized official

Name

Dr. Stjepan Steven Podstreleny, DDS

Title

Owner

Phone

(619) 795-0154

Specialties & licenses 1

Addresses

Other names 1

• Park Blvd Oral Surgery Doing business as

Part of

S Steven Podstreleny DDS PC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• S Steven Podstreleny, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Poway, CA
  • NPI 1922188150
  NPD (past)

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1023322468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032619",
            "telephone_number": "619-795-0154",
            "fax_number": "619-795-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032619",
            "telephone_number": "619-795-0154",
            "fax_number": "619-795-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. STEVEN PODSTRELENY, DDS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "S. STEVEN PODSTRELENY, DDS P.C.",
        "enumeration_date": "2010-07-27",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "PODSTRELENY",
        "authorized_official_first_name": "STJEPAN",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-795-0154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Blvd Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.