Individual provider Active NPI

Michael A. Stefan, DDS

  • General Practice Dentistry
  • Cuyahoga Falls, OH
National Provider Identifier
1114004140
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19197 Issued in OH
Practice address
330 Stow Ave
Cuyahoga Falls, OH 44221-2516
Phone
(330) 928-5575
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 19197 OH Primary

Addresses

Primary practice location

330 Stow Ave
Cuyahoga Falls, OH 44221-2516

Mailing address

5560 Governors Ave NW
Canton, OH 44718-1456
Phone (330) 966-8409

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
19197OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Barsan Family Dental Practice General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114004140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 GOVERNORS AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447181456",
            "telephone_number": "330-966-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 STOW AVE",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442212516",
            "telephone_number": "330-928-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFAN",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "19197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • 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.