Stephen Wade Johndreau, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7074 Issued in NE

Practice address

805 Pinecrest Dr
Chadron, NE 69337-2845

Phone

(860) 694-2377

Fax

(860) 694-2590

NPI assigned

Jul 8, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Johndreau Dental LLC

  • Dentist
  • Chadron, NE
  • NPI 1376222786
  NPD Authorized official

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1144661125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WAHOO DRIVE",
            "address_2": "ATTN: MR. MARK MAMMOTH",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PINECREST DR",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693372845",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNDREAU",
        "first_name": "STEPHEN",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taryn Jackson, PA-C
• Ann Jamison, PLMHP
• Sonya M Jensen, PHARMD
• Zachary Jensen, PHARM D
• Johndreau Dental LLC
• Daniel R. Johnson, D.D.S.
• David D Johnson, MD
• Kristin K Johnson, MD
• Murray Johnson, CRNA
• Rachel Ann Johnson, BSW

• Dentist in Chadron, NE
• Providers in Chadron, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.