Individual provider Active NPI

Steven Allen Fertig, D.M.D.

  • General Practice Dentistry
  • Kinston, NC
National Provider Identifier
1205866019
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5141 Issued in NC
Practice address
4990 US Highway 70 W
Kinston, NC 28504-7514
Phone
(252) 523-0544
Fax
(252) 523-4947
NPI assigned
Jul 4, 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
General Practice Dentistry 1223G0001X 5141 NC Primary

Addresses

Primary practice location

4990 US Highway 70 W
Kinston, NC 28504-7514

Mailing address

804 Arcane Cir
New Bern, NC 28562-7310
Phone (252) 638-2470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5141NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Walter J. Wulf, DDS, P.a. 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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205866019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 ARCANE CIR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285627310",
            "telephone_number": "252-638-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 US HIGHWAY 70 W",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285047514",
            "telephone_number": "252-523-0544",
            "fax_number": "252-523-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERTIG",
        "first_name": "STEVEN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.