Keith Andrew Stevener, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

50054495 Issued in NY

Practice address

527 E Genesee St
Fayetteville, NY 13066-1536

Phone

(315) 637-8213

NPI assigned

Jul 31, 2009

Sex

Male

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1396976981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661536",
            "telephone_number": "315-637-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENER",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "50054495",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "TD-00-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jud Staller, M.D.
• Kimberly J Staniec-Pinkerton, SLP
• Jennifer Starowicz
• Vicki Lynn Stenuf, RPH
• Irving Sterman, MD
• Gregory J Stock, DDS, MS
• Sandra Marie Sulik, MD
• Sunny Dental Fayetteville
• Lisa Marie Susko, RN
• Abigail Svarplaitis, PA

• Dentist in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.