Provider Demographics
NPI:1548316730
Name:HESS, STEVEN JAY (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAY
Last Name:HESS
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:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:CONOWINGO
Mailing Address - State:MD
Mailing Address - Zip Code:21918-0099
Mailing Address - Country:US
Mailing Address - Phone:410-378-9696
Mailing Address - Fax:410-378-9922
Practice Address - Street 1:49 ROCK SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CONOWINGO
Practice Address - State:MD
Practice Address - Zip Code:21918-1352
Practice Address - Country:US
Practice Address - Phone:410-378-9696
Practice Address - Fax:410-378-9922
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111631223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid