Provider Demographics
NPI:1235575283
Name:COCKEY, STEPHEN M (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:COCKEY
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 1:754 N HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3042
Mailing Address - Country:US
Mailing Address - Phone:410-879-5166
Mailing Address - Fax:410-879-5166
Practice Address - Street 1:754 N HICKORY AVE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3042
Practice Address - Country:US
Practice Address - Phone:410-879-5166
Practice Address - Fax:410-879-5166
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1326240771OtherNPI - ORGANIZATIONAL