Provider Demographics
NPI:1548358179
Name:STEPHENS, JAMES ROBIN (DDS, MSCD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBIN
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:DDS, MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:411 STRANDER BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2935
Mailing Address - Country:US
Mailing Address - Phone:206-575-1122
Mailing Address - Fax:206-575-1144
Practice Address - Street 1:411 STRANDER BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2935
Practice Address - Country:US
Practice Address - Phone:206-575-1122
Practice Address - Fax:206-575-1144
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA56791223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics