Van S. Stevens, DMD PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DI10062 Issued in NJ

Legal business name

VAN S. STEVENS, DMD PA

Practice address

213 Summit Rd
Mountainside, NJ 07092-2316

Phone

(908) 233-7711

Fax

(908) 233-0506

NPI assigned

Sep 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Van S. Stevens, DMD

Title

President

Phone

(908) 233-7711

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1346522299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-233-7711",
            "fax_number": "908-233-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-233-7711",
            "fax_number": "908-233-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN S. STEVENS, DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-233-7711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI10062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Mountainside, NJ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.