Active NPI
Stefan Jacob Gelven, DDS
- Dentist
- Ponca City, OK
National Provider Identifier
1063008316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7403
- Practice address
- 503 N 14TH St
Ponca City, OK 74601-4655 - Phone
- (580) 200-2282
- NPI assigned
- Dec 21, 2020
- Last updated
- Dec 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7403 | OK | Primary |
Addresses
Primary practice location
503 N 14TH St
Ponca City, OK 74601-4655
Mailing address
4599 N Washington St Apt 33D
Stillwater, OK 74075-1350
Phone (580) 304-1800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7403 | OK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608508800000",
"number": "1063008316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4599 N WASHINGTON ST APT 33D",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740751350",
"telephone_number": "580-304-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 N 14TH ST",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746014655",
"telephone_number": "580-200-2282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELVEN",
"first_name": "STEFAN",
"middle_name": "JACOB",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-21",
"last_updated": "2020-12-21",
"certification_date": "2020-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "7403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponca City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.