John J Stepanovich DDS

Primary specialty

DentistTaxonomy code 122300000X

License

07553 Issued in MI

Legal business name

JOHN J STEPANOVICH DDS

Practice address

260 Jefferson Ave SE
Grand Rapids, MI 49503-4597

Phone

(616) 459-1267

Fax

(616) 459-0673

NPI assigned

Aug 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John J Stepanovich, DDS

Title

Dentist

Phone

(616) 459-1267

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1629261235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034597",
            "telephone_number": "616-459-1267",
            "fax_number": "616-459-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034597",
            "telephone_number": "616-459-1267",
            "fax_number": "616-459-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J STEPANOVICH DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "STEPANOVICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-459-1267",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "07553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.

Verify at the official NPI Registry.