Provider Demographics
NPI:1073676649
Name:DORSCH, STEVE STEWART (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:STEWART
Last Name:DORSCH
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 1:15264 LOYALTY RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:VA
Mailing Address - Zip Code:20197-1214
Mailing Address - Country:US
Mailing Address - Phone:540-882-9242
Mailing Address - Fax:
Practice Address - Street 1:44340 PREMIER PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5025
Practice Address - Country:US
Practice Address - Phone:703-729-8700
Practice Address - Fax:703-729-5300
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008255174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA450038OtherANTHEM BCBS PROVIDER NUMB
VA450039OtherANTHEM BCBS PROVIDER NUMB
VAU73102Medicare UPIN