Carol W Stevens, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN11012 Issued in FL

Practice address

19180 Quesada Ave
Port Charlotte, FL 33948-1049

Phone

(941) 743-7474

NPI assigned

Feb 1, 2006

Sex

Female

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

Enrolled in FL

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

Medicare enrollment (NPD)

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.

• My Dentist of Port Charlotte PLLC

  • Dental Clinic/Center
  • Port Charlotte, FL
  • NPI 1811848328
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1235100645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19180 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481049",
            "telephone_number": "941-743-7474",
            "fax_number": "941-743-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19180 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481049",
            "telephone_number": "941-743-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CAROL",
        "middle_name": "W",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN11012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stepping Stone Kids Therapy LLC
• Edna Stercula, CRNA
• Lisa Stern
• Steven D Christesen MD PA
• Steven Jakubaitis DMD PA
• Deanna Stevens, HAS
• Grant Edward Stevens, HIS
• Theresa Stevens, HIS
• Troy Stevens
• Ashleigh Taylor Still, APRN, FNP-BC

• Periodontics in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.