Provider Demographics
NPI:1467867671
Name:STEMPER, JUSTINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUSTINE
Middle Name:
Last Name:STEMPER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:JUSTINE
Other - Middle Name:
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:8573 URBANDALE AVE
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4108
Mailing Address - Country:US
Mailing Address - Phone:515-279-3848
Mailing Address - Fax:
Practice Address - Street 1:8573 URBANDALE AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4108
Practice Address - Country:US
Practice Address - Phone:515-279-3848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-091121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice