Provider Demographics
NPI:1144360199
Name:DON, STEPHEN K (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:K
Last Name:DON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 S EL MOLINO AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2564
Mailing Address - Country:US
Mailing Address - Phone:626-793-6947
Mailing Address - Fax:626-793-0217
Practice Address - Street 1:175 S EL MOLINO AVE STE 5
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2564
Practice Address - Country:US
Practice Address - Phone:626-793-6947
Practice Address - Fax:626-793-0217
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0353901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice