Eric Stefanski, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013116A Issued in IN

Practice address

3410 Douglas Rd
South Bend, IN 46635

Phone

(574) 234-4117

NPI assigned

Jun 24, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zent Family Dentistry LLC

  • Dental Clinic/Center
  • South Bend, IN
  • NPI 1205680725
  NPD
• Cassopolis Dental, P.C.

  • General Practice Dentistry
  • Cassopolis, MI
  • NPI 1558743690
  NPD (past)
• Keep Mi Smile Cassopolis PC

  • Dental Clinic/Center
  • Cassopolis, MI
  • NPI 1366234031
  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1174905343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335",
            "city": "CASSOPOLIS",
            "state": "MI",
            "postal_code": "490310335",
            "telephone_number": "269-445-8636",
            "fax_number": "269-445-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46635",
            "telephone_number": "574-234-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANSKI",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021614",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013116A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Michael Statz, MD
• Judith Stayback
• Jeffrey Steele, MD
• Katherine L. Steele, PH.D.
• Tinelle Steely, PT
• Jason Stegink
• Susan Steibe-Pasalich, PH.D.
• Sorah Stein, M.A., BCBA, CSE
• Michael Frederick Steinberg, MD
• Morgan Anne Steinike

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.