S Steven Podstreleny, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

50861 Issued in CA

Practice address

15725 Pomerado Rd
Suite 205
Poway, CA 92064-2068

Phone

(858) 451-0200

Fax

(858) 451-0250

NPI assigned

Oct 16, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 12, 2022 through Apr 12, 2028

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.

• S. Steven Podstreleny, DDS, PC

  dba Park Blvd Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
  • NPI 1023322468
  NPD (past)
• Maryland Garden Dental

  • Dental Clinic/Center
  • Phoenix, AZ
  • NPI 1659586774
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1922188150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD",
            "address_2": "SUITE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642068",
            "telephone_number": "858-451-0200",
            "fax_number": "858-451-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD",
            "address_2": "SUITE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642068",
            "telephone_number": "858-451-0200",
            "fax_number": "858-451-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODSTRELENY",
        "first_name": "S",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Pina
• John Daniel Pinnix, DC
• Pinto NG Zhao OD Inc (PW Optometry)
• Chad Alan Pittman, BCBA
• Ronald Andrew Pobiner, DDS
• Gordon William Poelman, D.D.S.
• Lon Scott Poliner, M.D.
• Melissa Quinn Pollock, LCSW
• Madeline Polonia, PSY.D.
• Mackenzie Polu, RBT

• Oral and Maxillofacial Surgery (Dentist) in Poway, CA
• Providers in Poway, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.