Active NPI
Mark Curtis Stevens, JD DDS DENTIST ATTOR
- Periodontics
- New York, NY
National Provider Identifier
1861527160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 033102DENTIST
- Practice address
- 460 2ND Ave
Suite 8B
New York, NY 10016 - Phone
- (212) 385-4666
- NPI assigned
- Feb 23, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 033102DENTIST | NY | Primary |
Addresses
Primary practice location
460 2ND Ave
Suite 8B
New York, NY 10016
Mailing address
PO Box 495
New York, NY 10159
Phone (212) 679-2472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Juris Doctor
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033102DENTIST | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1861527160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 495",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10159",
"telephone_number": "212-679-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 2ND AVE",
"address_2": "SUITE 8B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "212-385-4666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "MARK",
"middle_name": "CURTIS",
"credential": "JD DDS DENTIST ATTOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "033102DENTIST",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.