Stephen Michael Gardner, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 19843 Issued in FL

Practice address

4530 Grand Blvd
New Port Richey, FL 34652-5119

Phone

(727) 849-4246

Fax

(727) 849-0701

NPI assigned

Jun 22, 2012

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Vincent J Monticciolo

  • Dental Clinic/Center
  • New Port Richey, FL
  • NPI 1760658413
  NPD (past)

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1912260001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 GRAND BLVD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346525119",
            "telephone_number": "727-849-4246",
            "fax_number": "727-849-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 GRAND BLVD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346525119",
            "telephone_number": "727-849-4246",
            "fax_number": "727-849-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 19843",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 19843",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Udayabhasker Gangapuram Reddy, M.D.
• Edimarie Garcia Guzman
• Dominick S Garcia
• Sahira Maria Garcia
• Darnell William Gardner, MSW
• Vera Lynn Gardner, LMT
• Maria Garfolo
• Doris Vanessa Gasangwa, MD
• Arianna Gash
• Kyera Shabazz Gaskin

• General Practice Dentistry in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.