Jenny Phung Stevens, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

31724 Issued in TX

Practice address

1100 Wilford Hall Loop, BLDG 4554
59 MDW/SGHC
Jbsa Lackland, TX 78236-9908

Phone

(210) 292-6225

NPI assigned

Jul 31, 2014

Last updated

Sep 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1386052538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "59 MDW/SGHC",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "59 MDW/SGHC",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-6225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-292-8611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JENNY",
        "middle_name": "PHUNG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NC",
            "license": "9833",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "31724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kierra Spivey, LCSW
• Brian Patrick Staak, MD
• Christine Stabile, OD
• Ross Stanley, DMD
• Yvette E Stephenson, RNC
• Kyle James Stevens, DO
• Jeremy Stewart, N.P/
• Suzanne B. Stinson, M.A., CCC-SP
• Michael Stringer, DPT
• Emily L Sturgill, MD

• Prosthodontics in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Prosthodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.