Individual provider Active NPI

Stephen E. Nechvatal, DMD PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lapeer, MI
National Provider Identifier
1629132352
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
SNO11747 Issued in MI
Practice address
1176 1/2 S Lapeer Rd Ste B
Lapeer, MI 48446-3385
Phone
(810) 667-6855
Fax
(810) 667-6875
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X SNO11747 MI Primary

Addresses

Primary practice location

1176 1/2 S Lapeer Rd Ste B
Lapeer, MI 48446-3385

Mailing address

1176 1/2 S Lapeer Rd Ste B
Lapeer, MI 48446-3385
Phone (810) 667-6855

Other identifiers 1

IdentifierTypeStateIssuer
SNO11747OtherMIORAL AND MAXILLOFACIAL SU

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SNO11747MIMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: snechvatal1142780@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1629132352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 1/2 S LAPEER RD STE B",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484463385",
            "telephone_number": "810-667-6855",
            "fax_number": "810-667-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 1/2 S LAPEER RD STE B",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484463385",
            "telephone_number": "810-667-6855",
            "fax_number": "810-667-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NECHVATAL",
        "first_name": "STEPHEN",
        "middle_name": "E.",
        "credential": "DMD PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "SNO11747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORAL AND MAXILLOFACIAL SU",
            "identifier": "SNO11747",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.