MARY BERNONA STEVENS DDS, PLLC (NPI# 1528678364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528678364 |
| Entity Type | Organization |
| Organization Name | MARY BERNONA STEVENS DDS, PLLC |
| Practice Address |
1172 Nixon Ave Nw Grand Rapids MI 49534-3638 |
| Practice Telephone | 6164530644 |
| Practice Fax Number | 6164530646 |
| Mailing Telephone | 6164530644 |
| Mailing Fax Number | 6164530646 |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |
| Authorized Official Name | DR. MARY BERNONA STEVENS (OWNER) |
| Authorized Official Telephone | 6165605740 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
1172 NIXON AVE NW |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49534-3638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819004 | Mary Bernona Stevens | Dentist | 1172 Nixon Ave Nw, Grand Rapids, MI 49544-3638 | 2005-05-23 |
| 1326485525 | Kevin John Stevens | Dentist | 1172 Nixon Ave Nw, Grand Rapids, MI 49534-3638 | 2013-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336792324 | Heather Duthler | Social Worker | 648 Kinney Ave Nw, Grand Rapids, MI 49534 | 2019-07-19 |
| 1114473550 | Tari Kruzel | Registered Nurse | 12955 3rd Ave Nw, Grand Rapids, MI 49534 | 2016-08-26 |
| 1972847184 | Indian Trails Camp, Inc. | Day Training, Developmentally Disabled Services | O-1859 Lake Michigan Dr. Nw, Grand Rapids, MI 49534 | 2012-11-15 |
| 1871743815 | Michael Robert Anderson Jr. | Chiropractor | 0-705 Tallmadge Woods Dr. Nw, Suite A, Grand Rapids, MI 49534 | 2008-09-26 |
| 1750459285 | Rick David Saier | Internal Medicine | 1175 Wilson Ave, Walker, MI 49534 | 2006-12-01 |
| 1154414886 | Edward D Young Dds PC | Dentist | 4310 Leonard Nw, Grand Rapids, MI 49534 | 2006-10-02 |
| 1558461756 | Sandra Staublin | Pediatrics | 4288 3 Mile Road, Walker, MI 49534 | 2006-09-25 |
| 1700986999 | Belinda Chou | Pediatrics | 4288 Three Mile Road, Walker, MI 49534 | 2006-09-25 |
| 1639196603 | David Robert Felton | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534 | 2006-07-16 |
| 1952349235 | Chiropractic Plus, P.C. | Chiropractor | 0 699 Tallmadge Wds Nw, Suite B, Grand Rapids, MI 49534 | 2006-06-02 |
| Find all providers in zip 49534 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739533 | Randy J Breen Dds Pllc | Clinic/Center | 2460 Burton St Se Ste 201, Grand Rapids, MI 49546-4800 | 2020-10-27 |
| 1720685399 | Elias Dental Lab | Clinic/Center | 535 Greenwood Ave Se Ste 100, Grand Rapids, MI 49506-2901 | 2020-10-06 |
| 1780291815 | Met & Associates, Plc | Clinic/Center | 2140b Wealthy St Se, Grand Rapids, MI 49506-3032 | 2020-09-23 |
| 1568075786 | D & J Dental Holdings Pllc | Clinic/Center | 2249 Wealthy St Se Ste 100, Grand Rapids, MI 49506-3055 | 2020-08-27 |
| 1023627163 | Grand Ridge Family Dentistry | Clinic/Center | 3350 Grand Ridge Dr Ne, Grand Rapids, MI 49525-7071 | 2020-07-24 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1801060702 | Randall W. Chambers, Dds, PC | Clinic/Center | 6143 28th St Se, Grand Rapids, MI 49546-6941 | 2008-04-22 |
| 1194855155 | County of Kent | Clinic/Center | 700 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2007-03-07 |
| 1114524881 | Joshua Palmateer Dmd and Katelyn Palmateer Dmd, Pllc | Clinic/Center | 4701 Plainfield Ave Ne, Grand Rapids, MI 49525-1644 | 2020-10-06 |
| 1699380584 | Vander Linde Family and Cosmetic Dentistry | Clinic/Center | 2609 Breton Rd Se, Grand Rapids, MI 49546-5631 | 2020-09-09 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49534 |
Please comment or provide details below to improve the information on MARY BERNONA STEVENS DDS, PLLC.
| 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.