Active NPI
David William Stevens, DDS
- General Practice Dentistry
- Taos, NM
National Provider Identifier
1255405528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901015705
- Practice address
- 1090 Goat Springs Rd.
Taos, NM 87571 - Phone
- (575) 758-6952
- Fax
- (575) 751-5210
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901015705 | MI | Primary |
Addresses
Primary practice location
1090 Goat Springs Rd.
Taos, NM 87571
Mailing address
PO Box 1946
Taos, NM 87571-1946
Phone (575) 758-6952
Other practice location 1
31450 W Seven Mile Rd
Suite 109
Livonia, MI 48152
Phone (248) 474-8100
Other practice location 2
1090 Goat Springs Rd.
Taos, NM 87571
Phone (575) 758-6952
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901015705 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keweenaw Bay Indian Community | 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.
-
- Federally Qualified Health Center (FQHC)
- Baraga, MI
- NPI 1336232289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1255405528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1946",
"city": "TAOS",
"state": "NM",
"postal_code": "875711946",
"telephone_number": "575-758-6952",
"fax_number": "575-751-5210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1090 GOAT SPRINGS RD.",
"city": "TAOS",
"state": "NM",
"postal_code": "87571",
"telephone_number": "575-758-6952",
"fax_number": "575-751-5210"
}
],
"practiceLocations": [
{
"address_1": "31450 W Seven Mile Rd",
"address_2": "Suite 109",
"address_purpose": "LOCATION",
"city": "Livonia",
"state": "MI",
"postal_code": "48152",
"country_code": "US",
"telephone_number": "248-474-8100",
"fax_number": "248-888-9593",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1090 Goat Springs Rd.",
"address_purpose": "LOCATION",
"city": "Taos",
"state": "NM",
"postal_code": "87571",
"country_code": "US",
"telephone_number": "575-758-6952",
"fax_number": "575-751-5210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEVENS",
"first_name": "DAVID",
"middle_name": "WILLIAM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901015705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.