Steven Mark Wolfram, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52164 Issued in CA

Practice address

11834 Bryant St
Suite #104
Yucaipa, CA 92399-3848

Phone

(909) 797-1452

Fax

(909) 790-0702

NPI assigned

Jun 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Steven Wolfram Dental Corporation

  dba Mountainside Dental Group

  • Dental Clinic/Center
  • Lake Forest, CA
  • NPI 1366253007
  NPD Authorized official
• Steven M Wolfram DDS Inc

  • Dental Clinic/Center
  • Yucaipa, CA
  • NPI 1780279430
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053348086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11834 BRYANT ST",
            "address_2": "SUITE #104",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923993848",
            "telephone_number": "909-797-1452",
            "fax_number": "909-790-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11834 BRYANT ST",
            "address_2": "SUITE #104",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923993848",
            "telephone_number": "909-797-1452",
            "fax_number": "909-790-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFRAM",
        "first_name": "STEVEN",
        "middle_name": "MARK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Wilson, MS, PPS
• Jeremy Michael Wilson
• Lukas Maxwell Wilson
• Penchitt Winkelman, FNP
• Karen Winston, M.D.
• Olivia Santos Wong Yu
• Lisa Wong-Soqui, FNP
• Vanessa I Worrell
• Amber Wright
• Craig Jackson Wright, D.D.S.

• General Practice Dentistry in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• General Practice Dentistry in California

• 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.