Robert J Stevenson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901018803 Issued in MI

Practice address

2641 Shirley Dr # 1
Jackson, MI 49201-8633

Phone

(517) 787-5367

Fax

(517) 787-4219

NPI assigned

Jun 26, 2008

Last updated

Jun 26, 2008By the provider in NPPES

Sex

Male

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 MI

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

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.

• Liberty Dentistry PLLC

  • Dental Clinic/Center
  • Ann Arbor, MI
  • NPI 1598415317
  Authorized official Same address or phone

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1326200924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 WILTSHIRE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036036",
            "telephone_number": "734-945-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 SHIRLEY DR # 1",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018633",
            "telephone_number": "517-787-5367",
            "fax_number": "517-787-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Mitchel Stern, MD
• Kayla Sterrett
• Caroline Marie Stevens, ATC
• Debra A Stevenson, RPH PHARMACIST
• Martine Stevenson
• Emily Stewart Stevens, PSYD, MA
• Perrise Stewart
• Heather Stiltner, MA, LPC, NCC, CTP-C
• Paige C. Stitt
• Chelsea Lynn Stokes

• Dentist in Jackson, MI
• Providers in Jackson, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.