Organization Active NPI

Stevenson and Cohen, a Professional Corporation

  • Endodontics
  • Vallejo, CA
National Provider Identifier
1053697128
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
STEVENSON AND COHEN, A PROFESSIONAL CORPORATION
Practice address
29 Rotary Way
Vallejo, CA 94591-8475
Phone
(707) 554-1764
NPI assigned
Nov 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Mark D Stevenson, DDS
Title
Secretary
Phone
(707) 544-1764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X CA Primary

Addresses

Primary practice location

29 Rotary Way
Vallejo, CA 94591-8475

Mailing address

29 Rotary Way
Vallejo, CA 94591-8475

Other identifiers 2

IdentifierTypeStateIssuer
1396843181OtherCAENDODONTIST
1366540148OtherCAENDODONTIST

National Provider Directory

National Provider Directory

Locations

29 Rotary Way
Vallejo, CA 94591
Phone (707) 554-1764

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1053697128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 ROTARY WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 ROTARY WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918475",
            "telephone_number": "707-554-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENSON AND COHEN, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "707-544-1764",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENDODONTIST",
            "identifier": "1396843181",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENDODONTIST",
            "identifier": "1366540148",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.