Provider Demographics
NPI:1437121530
Name:EIKENBERG, STEVEN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:EIKENBERG
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:HQS, USA DENTAC
Mailing Address - Street 2:2410 STANLEY ROAD
Mailing Address - City:FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-6200
Mailing Address - Country:US
Mailing Address - Phone:210-295-2743
Mailing Address - Fax:210-295-2602
Practice Address - Street 1:HQS, USA DENTAC
Practice Address - Street 2:2410 STANLEY ROAD
Practice Address - City:FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:210-295-2743
Practice Address - Fax:210-295-2602
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219501223G0001X
WI47861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice