Active NPI
Stephen Callan, DDS
- General Practice Dentistry
- Mesa, AZ
National Provider Identifier
1700958352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6961
- Practice address
- 2346 E Brown Rd
Mesa, AZ 85213-5255 - Phone
- (480) 969-3069
- Fax
- (480) 969-3419
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6961 | AZ | Primary |
Addresses
Primary practice location
2346 E Brown Rd
Mesa, AZ 85213-5255
Mailing address
2346 E Brown Rd
Mesa, AZ 85213-5255
Phone (480) 969-3069
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 147217 | Other | AZ | AHCCCS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6961 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1700958352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2346 E BROWN RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852135255",
"telephone_number": "480-969-3069",
"fax_number": "480-969-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2346 E BROWN RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852135255",
"telephone_number": "480-969-3069",
"fax_number": "480-969-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAN",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "6961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "147217",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.