Diane Petersen Stephens, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN009837 Issued in GA

Practice address

5370 US Highway 78
Suite 720
Stone Mountain, GA 30087-3574

Phone

(770) 465-3400

Fax

(770) 465-3480

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871521492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871128",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300870029",
            "telephone_number": "770-465-3400",
            "fax_number": "770-465-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5370 US HIGHWAY 78",
            "address_2": "SUITE 720",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873574",
            "telephone_number": "770-465-3400",
            "fax_number": "770-465-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DIANE",
        "middle_name": "PETERSEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN009837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00265911A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley T Staten
• Stay Right at Home Care for Seniors
• Katherine Long Steele, FNP
• Step in Faith Management Services of Georgia, Inc
• Stephens & Burrell Family Dentistry, LLC
• Steven Barnett PC
• Schadale Stevens, D.D.S
• Onasia Stewart
• Rena Stewart, DNP
• Trina Lorraine Stewart, PHARM.D.

• General Practice Dentistry in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.