Matthew Allen Stephenson, DDS

Individual provider Active NPI General Practice Dentistry · Brazoria, TX

NPI 1609986603 · NPPES record last updated Feb 26, 2008

Key facts

NPI
1609986603
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
15455 (TX)
Practice address
819 S Market St
Brazoria, TX 77422-5679
Phone
(979) 798-4493
Fax
(979) 798-4883
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15455TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Osga, PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15455 TX Yes

Addresses

Primary practice location

819 S Market St
Brazoria, TX 77422-5679

Mailing address

819 S Market St
Brazoria, TX 77422-5679
Phone (979) 798-4493

Other providers in Brazoria, TX

All providers in Brazoria, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.