Stephanie D. Govea

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110203 Issued in CA

Practice address

3369 Honeybrook Way Apt 4
Ontario, CA 91761-0314

Phone

(661) 201-2801

NPI assigned

May 15, 2023

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1609566488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3369 HONEYBROOK WAY APT 4",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917610314",
            "telephone_number": "661-201-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3369 HONEYBROOK WAY APT 4",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917610314",
            "telephone_number": "661-201-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVEA",
        "first_name": "STEPHANIE",
        "middle_name": "D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krysta R Gordon-Rand, M.S., MFTI
• Amy Leigh Gordon
• Svetlana Sofia Gorin
• Ryan Gorman
• Mauricio Gormaz
• Grace Renovation LLC
• Rigoberto Gracian
• Melissa Gradilla
• Samantha Jane Grady
• Zachary Martin Graffi

• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.