Individual provider Active NPI

Michael J. Stepovich, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Jose, CA
National Provider Identifier
1972801587
Registry record updated Mar 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
35786 Issued in CA
Practice address
1757 Blossom Hill Rd
Suite 30
San Jose, CA 95124-6212
Phone
(408) 358-2400
Fax
(408) 358-3250
NPI assigned
Mar 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 35786 CA Primary

Addresses

Primary practice location

1757 Blossom Hill Rd
Suite 30
San Jose, CA 95124-6212

Mailing address

1757 Blossom Hill Rd
Suite 30
San Jose, CA 95124-6212
Phone (408) 358-2400

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
35786CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1299369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299369600000",
    "number": "1972801587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 BLOSSOM HILL RD",
            "address_2": "SUITE 30",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246212",
            "telephone_number": "408-358-2400",
            "fax_number": "408-358-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 BLOSSOM HILL RD",
            "address_2": "SUITE 30",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246212",
            "telephone_number": "408-358-2400",
            "fax_number": "408-358-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPOVICH",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-06",
        "last_updated": "2011-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "35786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2011; 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.