Individual provider Active NPI

Stephen T. Dixon, D.D.S.

  • Endodontics
  • Santa Maria, CA
National Provider Identifier
1639259633
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
31454 Issued in CA
Practice address
1315 S Miller St
Suite 202
Santa Maria, CA 93454-6910
Phone
(805) 348-9188
NPI assigned
Oct 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 31454 CA Primary

Addresses

Primary practice location

1315 S Miller St
Suite 202
Santa Maria, CA 93454-6910

Mailing address

1315 S Miller St
Suite 202
Santa Maria, CA 93454-6910
Phone (805) 348-9188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415001721 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658679105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639259633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 S MILLER ST",
            "address_2": "SUITE 202",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546910",
            "telephone_number": "805-348-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S MILLER ST",
            "address_2": "SUITE 202",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546910",
            "telephone_number": "805-348-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "STEPHEN",
        "middle_name": "T.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "31454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.