Individual provider Active NPI

Gregory Eugene Stephens, D.D.S.

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1750591327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25996 Issued in CA
Practice address
4747 N 1St St
Suite 129
Fresno, CA 93726-0563
Phone
(559) 227-5466
Fax
(553) 227-5460
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 25996 CA Primary

Addresses

Primary practice location

4747 N 1St St
Suite 129
Fresno, CA 93726-0563

Mailing address

4747 N 1St St
Suite 129
Fresno, CA 93726-0563
Phone (559) 227-5466

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160509002396 CA Order and Referring Only - DentistPractitioner - Dentist 1355630641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Dental Care PastSince Jul 22, 2025 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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750591327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 N 1ST ST",
            "address_2": "SUITE 129",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260563",
            "telephone_number": "559-227-5466",
            "fax_number": "553-227-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 N 1ST ST",
            "address_2": "SUITE 129",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260563",
            "telephone_number": "559-227-5466",
            "fax_number": "553-227-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "GREGORY",
        "middle_name": "EUGENE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.