Active NPI
Dan Stephens, D.D.S.
- General Practice Dentistry
- Marietta, GA
National Provider Identifier
1356495717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8228
- Practice address
- 2480 Windy Hill Road
Marietta, GA 30067 - Phone
- (770) 952-0222
- Fax
- (770) 952-4969
- NPI assigned
- Jan 23, 2007
- 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 | 8228 | GA | Primary |
Addresses
Primary practice location
2480 Windy Hill Road
Marietta, GA 30067
Mailing address
2480 Windy Hill Rd SE
Suite 307
Marietta, GA 30067-8644
Phone (770) 952-0222
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 |
|---|---|---|---|
| 8228 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356495717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 WINDY HILL RD SE",
"address_2": "SUITE 307",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678644",
"telephone_number": "770-952-0222",
"fax_number": "770-952-4969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 WINDY HILL ROAD",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30067",
"telephone_number": "770-952-0222",
"fax_number": "770-952-4969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "DAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "8228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
- Stephanie Sandherr LLC (Up Pediatric Therapy)
- Brittany Leanne Stephen
- Karen Felicia Stephens-Vasser, NP
- Bryan Gilbert Stephens, LPC003199
- Carla Dianne Stephens, FNP-C
- Dan Bryan Stephens, M.D.
- Erica Fayer Stephens, PT, DPT
- Lori Beth Stephenson, RPH
- Robert H Stephenson Jr., MD
- Margaret Steranko, M.S., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.