Provider Demographics
NPI:1285862888
Name:ORTIZ-NEUSCHAEFER, STEPHANIE (RDH)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:ORTIZ-NEUSCHAEFER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 CASEY CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5283
Mailing Address - Country:US
Mailing Address - Phone:281-565-3611
Mailing Address - Fax:
Practice Address - Street 1:6127 N FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-5563
Practice Address - Country:US
Practice Address - Phone:281-550-3795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7516124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist