Individual provider Active NPI

Stephanie Elizabeth Patterson, DMD

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1053992297
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS044403 Issued in PA
Practice address
8127 Stenton Ave
Philadelphia, PA 19150-3530
Phone
(215) 844-1020
NPI assigned
Apr 19, 2021
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS044403 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

8127 Stenton Ave
Philadelphia, PA 19150-3530

Mailing address

1202 Ashbourne Rd
Elkins Park, PA 19027-2703
Phone (215) 704-5263

Other practice location 1

511 E 3rd St Unit 301
Bethlehem, PA 18015-2096
Phone (484) 526-2460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS044403PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant House Inc CurrentSince Jan 14, 2024 Accepting new patients
Covenant House Inc Single Specialty PastSince Jan 14, 2024 Accepting new patients

Locations

8127 Stenton Ave
Philadelphia, PA 19150
Phone (215) 844-1020

Interoperability endpoints

  • Direct secure messaging: stephanie.patterson.p1@direct.covenanthousehealth.nextgenshare.com
  • Direct secure messaging: stephanie.patterson.p1@direct.gpha.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1053992297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 ASHBOURNE RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272703",
            "telephone_number": "215-704-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8127 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503530",
            "telephone_number": "215-844-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 E 3rd St Unit 301",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180152096",
            "country_code": "US",
            "telephone_number": "484-526-2460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS044403",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.