Stephen W George, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN23848 Issued in FL

Practice address

606 W Magnolia St
Leesburg, FL 34748-5892

Phone

(352) 787-4800

NPI assigned

Sep 19, 2012

Last updated

Jul 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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 May 16, 2024 through May 16, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Stephen George DMD PLLC

  dba The Main Street Dentists, PLLC

  • Dental Clinic/Center
  • Leesburg, FL
  • NPI 1972174720
  NPD Authorized official
• The Main Street Dentists Inc

  • Dentist
  • Leesburg, FL
  • NPI 1265500565
  NPD (past)

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1700136645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 W MAGNOLIA ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485892",
            "telephone_number": "352-787-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 W MAGNOLIA ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485892",
            "telephone_number": "352-787-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6421 Saratoga Blvd Bldg 102",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784143480",
            "country_code": "US",
            "telephone_number": "361-992-0311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-19",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32544",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9769",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pedro L Geliga, MD
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• George M Mathew MD PA
• Garth O George, M.D.
• Gerard F. Melanson M.D., LLC
• Gi Experts,LLC
• Robert B Gibson, M.D.
• Birley Giddens III, OTR/L
• Gifted Hand Companions, LLC

• General Practice Dentistry in Leesburg, FL
• Providers in Leesburg, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.