NPIMap

Organization Active NPI

Harbor Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Gig Harbor, WA
National Provider Identifier
1902083108
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
005914 Issued in WA
Legal business name
HARBOR ORAL & MAXILLOFACIAL SURGERY
Practice address
5122 Olympic Dr NW Ste B106
Gig Harbor, WA 98335-1769
Phone
(253) 851-8880
Fax
(253) 858-2783
NPI assigned
Jan 30, 2008
Last updated
Jan 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Dr. Kerwin L Steffen, D.D.SNPI 1518022623
Title
Oral Surgeon
Phone
(253) 851-8880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 005914 WA Primary

Addresses

Primary practice location

5122 Olympic Dr NW Ste B106
Gig Harbor, WA 98335-1769

Mailing address

5122 Olympic Dr NW Ste B106
Gig Harbor, WA 98335-1769
Phone (253) 851-8880

National Provider Directory

National Provider Directory

Locations

5122 Olympic Dr
Ste B106
Gig Harbor, WA 98335
Phone (253) 851-8880

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1902083108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 OLYMPIC DR NW STE B106",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351769",
            "telephone_number": "253-851-8880",
            "fax_number": "253-858-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 OLYMPIC DR NW STE B106",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351769",
            "telephone_number": "253-851-8880",
            "fax_number": "253-858-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "STEFFEN",
        "authorized_official_first_name": "KERWIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "253-851-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "005914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.