Stephen L Kreizenbeck, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

40456 Issued in CA

Practice address

39-935 Vista del Sol, Suite 100
Rancho Mirage, CA 92270

Phone

(760) 837-1515

Fax

(760) 837-1011

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

No

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

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.

• Mirage Ambulatory Surgery Center, Inc

  • Oral and Maxillofacial Surgery Clinic/Center
  • Rancho Mirage, CA
  • NPI 1154644193
  NPD (past) Authorized official
• Kreizenbeck Seim Professional Partnership

  • Oral and Maxillofacial Surgery Clinic/Center
  • Rancho Mirage, CA
  • NPI 1073703922
  NPD (past)
• Mirage Aesthetic Concepts Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Rancho Mirage, CA
  • NPI 1538405345
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1962409268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39-935 VISTA DEL SOL, SUITE 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-837-1515",
            "fax_number": "760-837-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39-935 VISTA DEL SOL, SUITE 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-837-1515",
            "fax_number": "760-837-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIZENBECK",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "40456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neel Somasundar Kotrappa, MD
• Anastasia Kozyleva, DO
• Alice A Kraker, FNP
• Alexandria Esther Krakoff, BA
• Kreizenbeck Seim Professional Partnership
• James Krolopp, MD
• Abdallah Victor Kubbeh, M.D.
• Anuraag Ravi Kumar, DO, MBA
• Sonia Kurunathan, PT, DPT
• Katherine Magdalena Kwiecinska, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in Rancho Mirage, CA
• Providers in Rancho Mirage, 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 Oct 6, 2020; 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.