Individual provider Active NPI

Roy O. Stephens, DDS

  • Dentist
  • La Mesa, CA
National Provider Identifier
1124048749
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20592 Issued in CA
Practice address
7900 El Cajon Blvd
Suite D
La Mesa, CA 91941-3655
Phone
(619) 469-0494
Fax
(619) 667-9050
NPI assigned
Jul 19, 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
Dentist 122300000X 20592 CA Primary

Addresses

Primary practice location

7900 El Cajon Blvd
Suite D
La Mesa, CA 91941-3655

Mailing address

7900 El Cajon Blvd
Suite D
La Mesa, CA 91941-3655
Phone (619) 469-0494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160120002209 CA Order and Referring Only - DentistPractitioner - Dentist 8224331533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jessamine T. Sunglao DDS Inc 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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124048749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 EL CAJON BLVD",
            "address_2": "SUITE D",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413655",
            "telephone_number": "619-469-0494",
            "fax_number": "619-667-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 EL CAJON BLVD",
            "address_2": "SUITE D",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413655",
            "telephone_number": "619-469-0494",
            "fax_number": "619-667-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "ROY",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "20592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.