Mark Richard Stephenson, D. D. S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5422 Issued in NC

Practice address

6260 Glenwood Ave
Suite 106
Raleigh, NC 27612-2650

Phone

(919) 782-7275

Fax

(866) 509-6275

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

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.

• Alexander Resnansky DDS PA

  • Dentist
  • Raleigh, NC
  • NPI 1972644920
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902955685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 GLENWOOD AVE",
            "address_2": "SUITE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122650",
            "telephone_number": "919-782-7275",
            "fax_number": "866-509-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 GLENWOOD AVE",
            "address_2": "SUITE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122650",
            "telephone_number": "919-782-7275",
            "fax_number": "866-509-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7998075",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanice Monae Stephenson-Walcott, LCMHC
• Brigitte Jankavs Stephenson, MPH, RD, LDN
• Catherine Ann Stephenson, LCSW
• Cheryl Smith Stephenson, SLP
• Lars Stephenson, AGNP
• Michelle Elizabeth Stephenson
• Baron M Stepney
• Stepping Stones Pediatrics, PLLC
• Steps Ahead Therapy PLLC
• Debra Vincent Sterken, CCC/SLP

• General Practice Dentistry in Raleigh, NC
• Providers in Raleigh, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.