Stephen Robert John, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

32858 Issued in CA

Practice address

731 Walnut St
San Carlos, CA 94070-3179

Phone

(650) 430-0186

NPI assigned

Nov 6, 2013

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective May 21, 2019 through May 21, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Stephen R. John, DDS, Apc

  • Periodontics
  • San Carlos, CA
  • NPI 1588668008
  NPD Authorized official

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705190400000",
    "number": "1558790915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 DE ANZA BLVD. #41",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94402",
            "telephone_number": "650-430-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 WALNUT ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703179",
            "telephone_number": "650-430-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "STEPHEN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2024-01-14",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "32858",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "32858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana L Jimenez
• William Z Jing
• Neesha Jivan, DMD
• Joe Gutierez Inc
• John Greggory Edwards
• Anthony H. Johnson
• Lisa Johnson, MS, CGC
• Nisha Engineer Johnson
• Allison Elizabeth Jones
• Christopher David Jones

• Periodontics in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.