Individual provider Active NPI

Adam Matthew Stepniewski, D.D.S.

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1033122569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8596 Issued in OK
Practice address
4801 Richmond SQ
Oklahoma City, OK 73118-2058
Phone
(405) 840-5600
NPI assigned
Aug 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8596 OK Primary

Addresses

Primary practice location

4801 Richmond SQ
Oklahoma City, OK 73118-2058

Mailing address

217 NW 54TH St Apt C
Oklahoma City, OK 73118-7621
Phone (405) 514-7467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421000027 OK Order and Referring Only - DentistPractitioner - Dentist 9931407160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8596OKMDDentist
5896OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033122569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 NW 54TH ST APT C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731187621",
            "telephone_number": "405-514-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 RICHMOND SQ",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182058",
            "telephone_number": "405-840-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPNIEWSKI",
        "first_name": "ADAM",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "8596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.