Stevenson Dental Clinic for Children

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13513 Issued in TX

Legal business name

STEVENSON DENTAL CLINIC FOR CHILDREN

Practice address

11165 La Quinta Place
El Paso, TX 79936

Phone

(915) 591-1999

Fax

(915) 591-3201

NPI assigned

Nov 9, 2006

Last updated

Oct 1, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eugene Davis Stevenson Jr., DDS

Title

Owner

Phone

(915) 591-1999

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Professional Associate Other name

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1417027251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11165 LA QUINTA PLACE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79936",
            "telephone_number": "915-591-1999",
            "fax_number": "915-591-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11165 LA QUINTA PLACE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79936",
            "telephone_number": "915-591-1999",
            "fax_number": "915-591-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENSON DENTAL CLINIC FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-591-1999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "13513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA CHIP",
            "identifier": "G601421",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "828328",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111009002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "D13513",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Associate",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carol Lynn Stevens, LMSW
• Catie Stevens, LMT
• Daryl E. Stevens Sr., LCSW
• Robinson Stevens III, DNP, CRNA
• Victoria Stevens
• Stevenson Dialysis, LLC (El Paso Peritoneal Dialysis)
• Stevensons Dental Ark PLLC
• Verlaine M. Stewart-Ray, NP
• Adam Eugene Stewart, OT
• Lauren Stewart, M.S., SLP-CFY

• Pediatric Dentistry in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.