Provider Demographics
NPI:1902918220
Name:IRWIN, STEVEN R (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:IRWIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:R
Other - Last Name:IRWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3555 NE RALPH POWELL RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064
Mailing Address - Country:US
Mailing Address - Phone:816-347-9933
Mailing Address - Fax:816-347-9314
Practice Address - Street 1:3555 NE RALPH POWELL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064
Practice Address - Country:US
Practice Address - Phone:816-347-9933
Practice Address - Fax:816-347-9314
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO014233122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist