NPIMap

Organization Active NPI

Stephan Family Dental a Dental Corporation

Doing business as Stephan Dental

  • Dentist
  • El Cajon, CA
National Provider Identifier
1336565092
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
STEPHAN FAMILY DENTAL A DENTAL CORPORATION
Doing business as
Stephan Dental
Practice address
860 Jamacha Rd
Suite 201
El Cajon, CA 92019-6206
Phone
(619) 593-3000
Fax
(619) 593-3002
NPI assigned
Mar 5, 2014
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Waleed Stephan, DDSNPI 1841477387
Title
Dentist
Phone
(619) 593-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

860 Jamacha Rd
Suite 201
El Cajon, CA 92019-6206

Mailing address

860 Jamacha Rd
Suite 201
El Cajon, CA 92019-6206
Phone (619) 593-3000

Other names 1

  • Stephan Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1336565092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 JAMACHA RD",
            "address_2": "SUITE 201",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920196206",
            "telephone_number": "619-593-3000",
            "fax_number": "619-593-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 JAMACHA RD",
            "address_2": "SUITE 201",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920196206",
            "telephone_number": "619-593-3000",
            "fax_number": "619-593-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHAN FAMILY DENTAL A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "STEPHAN",
        "authorized_official_first_name": "WALEED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "619-593-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephan Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stephan Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.