Individual provider Active NPI

Robert Benjamin Stevenson III, DDS MS

  • Prosthodontics
  • Columbus, OH
National Provider Identifier
1679792360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
15347 Issued in OH
Practice address
3600 Olentangy River Road
Suite D3
Columbus, OH 43214-3437
Phone
(614) 451-2767
Fax
(614) 451-2988
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

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
Prosthodontics 1223P0700X 15347 OH Primary

Addresses

Primary practice location

3600 Olentangy River Road
Suite D3
Columbus, OH 43214-3437

Mailing address

3600 Olentangy River Road
Suite D3
Columbus, OH 43214-3437
Phone (614) 451-2767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 6, 2016 through Jul 6, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
15347OHMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679792360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OLENTANGY RIVER ROAD",
            "address_2": "SUITE D3",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143437",
            "telephone_number": "614-451-2767",
            "fax_number": "614-451-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OLENTANGY RIVER ROAD",
            "address_2": "SUITE D3",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143437",
            "telephone_number": "614-451-2767",
            "fax_number": "614-451-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "ROBERT",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OH",
            "license": "15347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.