Timothy Stevens, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

59721 Issued in CA

Practice address

1745 S Imperial Ave Ste 107
El Centro, CA 92243-4243

Phone

(760) 353-7603

NPI assigned

Sep 9, 2005

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)

Enrolled

State licenses

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1164416731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 S IMPERIAL AVE STE 107",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434243",
            "telephone_number": "760-353-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 S IMPERIAL AVE STE 107",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434243",
            "telephone_number": "760-353-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TIMOTHY",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "59721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen E. Gocke M.D. Inc.
• Stephens Anesthesia Services, Inc
• Steven E. Blum DO PC
• Adrianna Stevens
• Charles Raymond Stevens, M.D.
• Evelyn Margaret Stills
• Scott Christopher Stirling, MD
• Jayme Lynn Storms, N.P.
• Kyanna M Strain
• John Marshall Strong, M.D.

• Oral and Maxillofacial Surgery (Dentist) in El Centro, CA
• Providers in El Centro, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.