Provider Demographics
NPI:1326118803
Name:PAYNE, STEPHEN K (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:K
Last Name:PAYNE
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 1:13301 MIDLOTHIAN TPKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13301 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE A
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4211
Practice Address - Country:US
Practice Address - Phone:808-379-0875
Practice Address - Fax:804-379-3308
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice