Individual provider Active NPI

Stephen Frank Rupert, D.D.S.

  • General Practice Dentistry
  • Aberdeen, WA
National Provider Identifier
1528063294
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00004670 Issued in WA
Practice address
950 Oak St
Aberdeen, WA 98520-1041
Phone
(360) 533-5104
Fax
(360) 533-1202
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 DE00004670 WA Primary

Addresses

Primary practice location

950 Oak St
Aberdeen, WA 98520-1041

Mailing address

950 Oak St
Aberdeen, WA 98520-1041
Phone (360) 533-5104

Other identifiers 1

IdentifierTypeStateIssuer
5388707MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20170210001171 WA Order and Referring Only - DentistPractitioner - Dentist 1153604418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rupert Family Dentistry General Practice Current Accepting new patients

Locations

950 Oak St
Aberdeen, WA 98520
Phone (360) 533-5104

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528063294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 OAK ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201041",
            "telephone_number": "360-533-5104",
            "fax_number": "360-533-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 OAK ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201041",
            "telephone_number": "360-533-5104",
            "fax_number": "360-533-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPERT",
        "first_name": "STEPHEN",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00004670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5388707",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.