Individual provider Active NPI

George Matthew Stephens, DDS

  • General Practice Dentistry
  • Salisbury, MD
National Provider Identifier
1730182726
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6730 Issued in MD
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, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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 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

IdentifierTypeStateIssuer
613100000MedicaidMD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831001113 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133435597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6730MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.