Provider Demographics
NPI:1629416201
Name:STEPHENSON, JOSANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSANNA
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JOSANNA
Other - Middle Name:
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7940 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-9618
Mailing Address - Country:US
Mailing Address - Phone:402-423-3333
Mailing Address - Fax:
Practice Address - Street 1:7940 S 13TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-9618
Practice Address - Country:US
Practice Address - Phone:402-423-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE70771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice