Dejon Stephens

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

KK554811 Issued in CA

Practice address

824 E 87TH St
Los Angeles, CA 90002-1019

Phone

(323) 547-3819

NPI assigned

Jan 17, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1588315972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14420 ELSWORTH ST STE 102",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539027",
            "telephone_number": "323-547-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 E 87TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900021019",
            "telephone_number": "323-547-3819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14420 Elsworth St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925539027",
            "country_code": "US",
            "telephone_number": "323-547-3819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DEJON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "KK554811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen L Bland MD Medical Corp
• Stephen Weisberg DDS Inc
• F. Otis Stephen, M.D.
• Brooke Stephens
• Christine Stephens
• Heather Marie Stephens
• Jhaina Stephens
• Juanetta Stephens
• Keontea Mark Stephens
• Kimberley Ann Stephens

• Prosthetic/Orthotic Supplier in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.