Provider Demographics
NPI:1700560190
Name:STEVENS, JAIME CARDASCIA (DMD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:CARDASCIA
Last Name:STEVENS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:NICOLE
Other - Last Name:CARDASCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:9216 SW 72ND CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-0257
Mailing Address - Country:US
Mailing Address - Phone:239-777-5442
Mailing Address - Fax:
Practice Address - Street 1:4631 NW BLITCHTON RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-4020
Practice Address - Country:US
Practice Address - Phone:352-619-9414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18039122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist