John Walter Stevenson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

1414606 Issued in MI

Practice address

22 S Main St
Clarkston, MI 48346-1524

Phone

(248) 625-8494

Fax

(248) 922-0476

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan Mainstreet Dentistry PLC

  • General Practice Dentistry
  • Clarkston, MI
  • NPI 1144774274
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689788515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S MAIN ST",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461524",
            "telephone_number": "248-625-8494",
            "fax_number": "248-922-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S MAIN ST",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461524",
            "telephone_number": "248-625-8494",
            "fax_number": "248-922-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JOHN",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "1414606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Steinhelper, CSW
• Laura Stephens, MS, LLP, BCBA
• Steven J Rollins DMD PC
• Corey A Stevenson, LLMSW
• Darian Stevenson
• Sunnie Stewart, RN
• Susan Ann Stewart, M.A.,L.L.P.,L.M.S.W.
• Lisa Marie Stoll, LMSW
• Victoria Stoll
• Carrie Stollman, LLMSW

• Dentist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Dentist in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.