Individual provider Active NPI

Stephen Allen Chastain, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1720092083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3929 Issued in OK
Practice address
11900 N Pennsylvania Ave
Suite a-1
Oklahoma City, OK 73120-7824
Phone
(405) 755-9050
Fax
(405) 751-3112
NPI assigned
Jul 29, 2006
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
General Practice Dentistry 1223G0001X 3929 OK Primary

Addresses

Primary practice location

11900 N Pennsylvania Ave
Suite a-1
Oklahoma City, OK 73120-7824

Mailing address

11900 N Pennsylvania Ave
Suite a-1
Oklahoma City, OK 73120-7824
Phone (405) 755-9050

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

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720092083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 N PENNSYLVANIA AVE",
            "address_2": "SUITE A-1",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731207824",
            "telephone_number": "405-755-9050",
            "fax_number": "405-751-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 N PENNSYLVANIA AVE",
            "address_2": "SUITE A-1",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731207824",
            "telephone_number": "405-755-9050",
            "fax_number": "405-751-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "STEPHEN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "3929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.