Active NPI
Steven M Sebso, DDS
- General Practice Dentistry
- Phoenix, AZ
National Provider Identifier
1316905011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D2166
- Practice address
- 1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228 - Phone
- (623) 434-9343
- Fax
- (623) 321-6268
- NPI assigned
- May 2, 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 | D2166 | AZ | Primary |
Addresses
Primary practice location
1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228
Mailing address
810 W Jerome Cir
Mesa, AZ 85210-5939
Phone (623) 434-9343
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 097148 | Medicaid | AZ |
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 |
|---|---|---|---|
| D2166 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1316905011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 W JEROME CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852105939",
"telephone_number": "623-434-9343",
"fax_number": "623-321-6268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1904 W PARKSIDE LN",
"address_2": "SUITE 201",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850271228",
"telephone_number": "623-434-9343",
"fax_number": "623-321-6268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEBSO",
"first_name": "STEVEN",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D2166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "097148",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.