Active NPI
Stephen Edward Soehren, D.D.S.
- Periodontics
- Sterling Heights, MI
National Provider Identifier
1629188180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 015767
- Practice address
- 35409 Schoenherr Rd
Sterling Heights, MI 48312-4258 - Phone
- (586) 268-1354
- NPI assigned
- Aug 30, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 015767 | MI | Primary |
Addresses
Primary practice location
35409 Schoenherr Rd
Sterling Heights, MI 48312-4258
Mailing address
6223 Wood Pond Rd
West Bloomfield, MI 48323-2264
Phone (248) 738-8336
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
| License | State | Type | Specialty |
|---|---|---|---|
| 015767 | MI | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Periodontic PLLC | Periodontics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Periodontics
- Wyandotte, MI
- NPI 1205014669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629188180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6223 WOOD POND RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483232264",
"telephone_number": "248-738-8336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35409 SCHOENHERR RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483124258",
"telephone_number": "586-268-1354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOEHREN",
"first_name": "STEPHEN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "015767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.