Individual provider Active NPI

Stevan Paul Dumas, D.D.S.

  • General Practice Dentistry
  • Culver City, CA
National Provider Identifier
1134260656
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29260 Issued in CA
Practice address
3831 Hughes Ave Ste 610
Culver City, CA 90232-6853
Phone
(310) 559-3401
Fax
(310) 559-3405
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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 29260 CA Primary

Addresses

Primary practice location

3831 Hughes Ave Ste 610
Culver City, CA 90232-6853

Mailing address

3831 Hughes Ave Ste 610
Culver City, CA 90232-6853
Phone (310) 559-3401

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
I20160210001454 CA Order and Referring Only - DentistPractitioner - Dentist 9537463617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29260CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1134260656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 610",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326853",
            "telephone_number": "310-559-3401",
            "fax_number": "310-559-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 610",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326853",
            "telephone_number": "310-559-3401",
            "fax_number": "310-559-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAS",
        "first_name": "STEVAN",
        "middle_name": "PAUL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.