Individual provider Active NPI

Valentine Stephen, DDS

  • Dentist
  • Dallas, TX
National Provider Identifier
1740264878
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23615 Issued in TX
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, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
26-2455983OtherTXFEDERAL 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160323000321 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6608180146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23615TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.