Bruce A. Stephenson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27075 Issued in CA

Practice address

345 Estudillo Ave
Suite 102
San Leandro, CA 94577-4702

Phone

(510) 483-2164

Fax

(510) 483-1671

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740324607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 ESTUDILLO AVE",
            "address_2": "SUITE 102",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774702",
            "telephone_number": "510-483-2164",
            "fax_number": "510-483-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 ESTUDILLO AVE",
            "address_2": "SUITE 102",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774702",
            "telephone_number": "510-483-2164",
            "fax_number": "510-483-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "BRUCE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A Stein, DPM
• Miritte Robin Steinberg, ASW
• Jennifer A Stejskal, MFTI
• Courtney Nicol Stephens, MSW,ASW
• Dennis Stephens, M.D.
• Tamryn Stephenson
• Caitlin Laurie Sterling
• Steven I. Subotnick, DPM,Ms a Professional Corporation
• Melissa Stevens, PSY.D.W.
• Monique Yvette Stevens, M.D.

• General Practice Dentistry in San Leandro, CA
• Providers in San Leandro, CA by specialty
• General Practice Dentistry in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.