Active NPI
John Russell Stephens, D.D.S.
- Dentist
- Killeen, TX
National Provider Identifier
1962420182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12910
- Practice address
- 2601 E Elms Rd
Killeen, TX 76542-2804 - Phone
- (254) 699-4127
- Fax
- (254) 699-4130
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12910 | TX | Primary |
Addresses
Primary practice location
2601 E Elms Rd
Killeen, TX 76542-2804
Mailing address
2601 E Elms Rd
P.O. Box 11022
Killeen, TX 76542-2804
Phone (254) 699-4127
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D12910 | Other | TX | BC/BS |
| 689845 | Other | TX | UNITED CONCORDIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12910 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Muszynski Dental, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Killeen, TX
- NPI 1861903601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962420182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 E ELMS RD",
"address_2": "P.O. BOX 11022",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765422804",
"telephone_number": "254-699-4127",
"fax_number": "254-699-4130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 E ELMS RD",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765422804",
"telephone_number": "254-699-4127",
"fax_number": "254-699-4130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "JOHN",
"middle_name": "RUSSELL",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "12910",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "D12910",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "689845",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- 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.