Individual provider Active NPI

Fred Stepen, D.D.S.

  • General Practice Dentistry
  • Beverly Hills, CA
National Provider Identifier
1114019726
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25995 Issued in CA
Practice address
436 N Roxbury Dr Ste 108
Beverly Hills, CA 90210-5016
Phone
(310) 888-8757
Fax
(310) 273-7553
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

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 25995 CA Primary

Addresses

Primary practice location

436 N Roxbury Dr Ste 108
Beverly Hills, CA 90210-5016

Mailing address

436 N Roxbury Dr Ste 108
Beverly Hills, CA 90210-5016
Phone (310) 888-8757

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
25995CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114019726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N ROXBURY DR STE 108",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105016",
            "telephone_number": "310-888-8757",
            "fax_number": "310-273-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N ROXBURY DR STE 108",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105016",
            "telephone_number": "310-888-8757",
            "fax_number": "310-273-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPEN",
        "first_name": "FRED",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

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.