Provider Demographics
NPI:1043484256
Name:STEVENS, JESSICA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 S WADSWORTH BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-4800
Mailing Address - Country:US
Mailing Address - Phone:303-867-3701
Mailing Address - Fax:
Practice Address - Street 1:3190 S WADSWORTH BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-4800
Practice Address - Country:US
Practice Address - Phone:303-867-3701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO96491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice