Provider Demographics
NPI:1093941601
Name:STEPHEN DENT M.D. INC.
Entity Type:Organization
Organization Name:STEPHEN DENT M.D. INC.
Other - Org Name:SAN DIEGO EAR, NOSE THROAT SPECILAISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLOSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:COPM
Authorized Official - Phone:760-479-2100
Mailing Address - Street 1:2027 NEWCASTLE AVE
Mailing Address - Street 2:1197 PO BOX
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1751
Mailing Address - Country:US
Mailing Address - Phone:760-479-2100
Mailing Address - Fax:760-479-2101
Practice Address - Street 1:2020 CASSIA RD STE 101
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4211
Practice Address - Country:US
Practice Address - Phone:760-479-2100
Practice Address - Fax:619-858-0928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty