Individual provider Active NPI

Steve M Pitcher, DDS

  • General Practice Dentistry
  • Saint James, MN
National Provider Identifier
1376608240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9051 Issued in MN
Practice address
506 1St Ave S
Saint James, MN 56081-1728
Phone
(507) 375-7272
Fax
(507) 375-3046
NPI assigned
Dec 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9051 MN Primary

Addresses

Primary practice location

506 1St Ave S
Saint James, MN 56081-1728

Mailing address

1103 12TH Ave N
Saint James, MN 56081-2032
Phone (507) 375-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 28, 2023 through Aug 28, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376608240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 12TH AVE N",
            "city": "SAINT JAMES",
            "state": "MN",
            "postal_code": "560812032",
            "telephone_number": "507-375-4010",
            "fax_number": "507-375-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 1ST AVE S",
            "city": "SAINT JAMES",
            "state": "MN",
            "postal_code": "560811728",
            "telephone_number": "507-375-7272",
            "fax_number": "507-375-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITCHER",
        "first_name": "STEVE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, MN

Sources for this page

Verify at the official NPI Registry.