RANDOLPH M. STEVENS


Address: Coastal Endodontic Associates, 1804 Frederica Rd., Ste B, St. Simons Island, GA 31522
Phone: 9126386664

RANDOLPH M. STEVENS (NPI# 1770775116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770775116
Entity Type Individual
Full Name RANDOLPH M. STEVENS
Credential DDS,PC
Practice Address Coastal Endodontic Associates
1804 Frederica Rd., Ste B
St. Simons Island
GA 31522
Practice Telephone 9126386664
Practice Fax Number 9126380298
Mailing Telephone 9126386664
Mailing Fax Number 9126380298
Enumeration Date 2007-08-09
Last Update Date 2007-08-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223E0200X Dentist
Specialization: Endodontics
GA9595 GA Dental Providers

Office Location

Street Address COASTAL ENDODONTIC ASSOCIATES
1804 FREDERICA RD., STE B
City ST. SIMONS ISLAND
State GA
Zip Code 31522

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982186342 Matthew Mackinnon Gibbs Specialist/Technologist 211 Village Dr, St Simons Is, GA 31522 2018-09-02
1770957433 Jennifer Herrin, Lpc Community/Behavioral Health 400 Main Street, Cottage 1, Saint Simons Island, GA 31522 2015-11-18
1508113002 Ashley Neal Callicutt Counselor 301 Sea Island Road, Suite G, St. Simons Island, GA 31522 2012-08-14
1235414103 Dana D'andrea Duggan Psychologist 283 Redfern Village, St. Simons Island, GA 31522 2011-10-11
1528394848 Nancy Hodges Bowen Nurse Practitioner 7000 Wellness Way, Suite 130, St. Simons Island, GA 31522 2009-10-21
1073763215 John Arthur Hendry Dentist 511 Mallery Street, St. Simons Island, GA 31522 2008-09-24
1689797383 Angela C Barnard Nurse Practitioner 798 Mallery St Apt 2, Saint Simons Island, GA 31522 2007-04-09
1053493486 Larry D. Daugherty Dentist 124 Island Professional Park, St Simons Island, GA 31522 2006-10-19
1134239460 Joe Neil Garner Dentist 288 Redfern Village, St Simons Island, GA 31522 2006-08-30
1467464438 Louis Anthony Barton Psychiatry & Neurology 2927 Demere Rd., St. Simons Island, GA 31522 2006-08-11
Find all providers in zip 31522

Taxonomy Information

Taxonomy Code 1223E0200X
Grouping Dental Providers
Classification Dentist
Specialization Endodontics

Taxonomy Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437764180 John O. Green, II, Dds, PC Dentist 6126 Prestley Mill Rd Ste J, Douglasville, GA 30134-5624 2020-09-10
1104434232 Conyers Endodontic Center PC Dentist 1920 Highway 20 Se Ste A, Conyers, GA 30013-2048 2020-07-15
1790288678 Crabapple Endodontics Dentist 12385 Crabapple Rd Ste 150, Alpharetta, GA 30004-6357 2018-03-16
1326552522 Lucas Blaine Connor Dentist 3625 Braselton Hwy Ste 101, Dacula, GA 30019-4696 2017-11-27
1710382007 Golden Isles Endodontics, LLC Dentist 1804 Frederica Rd Ste B, Saint Simons Island, GA 31522-2044 2014-10-29
1346644176 Liberty Trails Endodontics, LLC Dentist 111 E Mills Ave, Hinesville, GA 31313-2616 2014-10-22
1194136929 Jimmy W. Arnold Dentist 152 N Crest Blvd Ste A, Macon, GA 31210-1847 2014-05-14
1629418371 Young Okeke Dentist 6595 Roswell Rd Ste G-3040, Atlanta, GA 30328-3152 2013-06-26
1720342694 Lake Oconee Endodontics, LLC Dentist 112 Harmony Crossing, Suite 1, Eatonton, GA 31024-9536 2012-06-26
1275891541 Alison Stpaul Dentist 1705 Ga-20, Suite 200, Mcdonough, GA 30253 2012-04-24
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Competitor

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City ST. SIMONS ISLAND
Zip Code 31522

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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