JUSTIN M STEPHENS (NPI# 1952959322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952959322 |
| Entity Type | Individual |
| Full Name | JUSTIN M STEPHENS |
| Credential | DMD |
| Practice Address |
4164 S Broadway Ave Tyler TX 75701-8719 |
| Mailing Address |
3145 Vineyard Tyler TX 75701-8511 |
| Practice Telephone | 9037057574 |
| Mailing Telephone | 9037059191 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
35705 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699180851 | Justin Stephens | Nursing Care | 16190 Jacobs Rd, Watertown, NY 13601-5602 | 2014-06-26 |
| 1184273963 | Justin Stephens | Physician Assistant | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2019-09-05 |
| Street Address |
4164 S BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-8719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629598586 | Kunduru Dental Pllc | Dentist | 4164 S Broadway Ave, Tyler, TX 75701-8719 | 2017-06-22 |
| 1821616186 | Honglam Thi Vo | Dentist | 4164 S Broadway Ave, Tyler, TX 75701-8719 | 2020-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329534 | Professional Dental Alliance of Tx 43004 Pllc | Dentist | 212 Old Grande Blvd Ste B224, Tyler, TX 75703-4277 | 2020-09-02 |
| 1679183446 | Valerie Marie Cano | Dentist | 7223 Crosswater, Tyler, TX 75703-0719 | 2020-08-05 |
| 1033770227 | Rajamanoj Kondaveeti | Dentist | 3873 Tx-64, Tyler, TX 75704 | 2019-06-27 |
| 1538720016 | Trevor Justin Wortley | Dentist | 8942 S Broadway Ave Ste 128, Tyler, TX 75703-5443 | 2019-06-25 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1992217947 | Charles Cox IIi | Dentist | 1327 S Baxter Ave, Tyler, TX 75701-3404 | 2017-10-31 |
| 1326559022 | Blu Dental Group PC | Dentist | 3975 Old Jacksonville Rd, Tyler, TX 75701-8519 | 2017-10-20 |
| 1629598586 | Kunduru Dental Pllc | Dentist | 4164 S Broadway Ave, Tyler, TX 75701-8719 | 2017-06-22 |
| Find all providers in TYLER | ||||
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| 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.