Active NPI
Valentine Stephen, DDS
- Dentist
- Dallas, TX
National Provider Identifier
1740264878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 23615
- Practice address
- 2037 S Buckner Blvd
Dallas, TX 75217-1824 - Phone
- (214) 398-2545
- Fax
- (214) 398-2017
- NPI assigned
- Dec 1, 2005
- Last updated
- Sep 9, 2008
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 23615 | TX | Primary |
Addresses
Primary practice location
2037 S Buckner Blvd
Dallas, TX 75217-1824
Mailing address
2037 S Buckner Blvd
Dallas, TX 75217-1824
Phone (214) 398-2545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26-2455983 | Other | TX | FEDERAL TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- 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 |
|---|---|---|---|---|
| I20160323000321 | TX | Order and Referring Only - Other (Physician) | 6608180146 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23615 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen Family Dentistry, PC | 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.
-
- General Practice Dentistry
- Dallas, TX
- NPI 1982843660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1740264878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2037 S BUCKNER BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752171824",
"telephone_number": "214-398-2545",
"fax_number": "214-398-2017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2037 S BUCKNER BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752171824",
"telephone_number": "214-398-2545",
"fax_number": "214-398-2017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHEN",
"first_name": "VALENTINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "23615",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "26-2455983",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.