Active NPI
George Matthew Stephens, DDS
- General Practice Dentistry
- Salisbury, MD
National Provider Identifier
1730182726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6730
- Practice address
- 705 N Salisbury Blvd
Salisbury, MD 21801-4120 - Phone
- (410) 334-3401
- Fax
- (410) 546-5090
- NPI assigned
- May 24, 2005
- Last updated
- May 13, 2016
- 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 | 6730 | MD | Primary |
Addresses
Primary practice location
705 N Salisbury Blvd
Salisbury, MD 21801-4120
Mailing address
705 N Salisbury Blvd
Salisbury, MD 21801-4120
Phone (410) 334-3401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 613100000 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150831001113 | MD | Order and Referring Only - Oral Surgery | 9133435597 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6730 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wicomico County Health Department | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Public Health or Welfare Agency
- Salisbury, MD
- NPI 1508946047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1730182726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 N SALISBURY BLVD",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218014120",
"telephone_number": "410-334-3401",
"fax_number": "410-546-5090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 N SALISBURY BLVD",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218014120",
"telephone_number": "410-334-3401",
"fax_number": "410-546-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "GEORGE",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "6730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "613100000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.