Robert C. Stetzel Jr., BS, BA, MS, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS4676 Issued in TN

Practice address

2900 Kirby Parkway, Ste 9
Memphis, TN 38119-8207

Phone

(901) 755-7392

Fax

(901) 755-6442

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Bachelor of Science, Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smile Makers of Memphis PC

  • General Practice Dentistry
  • Memphis, TN
  • NPI 1992921381
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1821150293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7205 GRAPETREE TRL",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187946",
            "telephone_number": "901-266-0108",
            "fax_number": "901-266-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 KIRBY PARKWAY, STE 9",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198207",
            "telephone_number": "901-755-7392",
            "fax_number": "901-755-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETZEL",
        "first_name": "ROBERT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "BS, BA, MS, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2750",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS4676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5441837",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiara Stepter-Woods
• Clesheree Stepter, NP
• Ronald Stepter II
• Natalie Sterling
• Kathleen Shirley Stern, M.D.
• Steven N. Rice
• Angela Ervin Stevens, B.C.B.A
• Claude Carroll Stevens, D.C.
• Jacob Stevens
• Kahdejah Evonne Stevens, CAMS

• Dentist in Memphis, TN
• Providers in Memphis, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.