Provider Demographics
NPI:1033122569
Name:STEPNIEWSKI, ADAM MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MATTHEW
Last Name:STEPNIEWSKI
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 1:217 NW 54TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7621
Mailing Address - Country:US
Mailing Address - Phone:405-514-7467
Mailing Address - Fax:
Practice Address - Street 1:4801 RICHMOND SQ
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2058
Practice Address - Country:US
Practice Address - Phone:405-840-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8596122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist