Provider Demographics
NPI:1679795140
Name:NERAD, STEVEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:NERAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 SERPENTINE LN
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4716
Mailing Address - Country:US
Mailing Address - Phone:925-846-3336
Mailing Address - Fax:
Practice Address - Street 1:1024 SERPENTINE LANE
Practice Address - Street 2:SUITE 107
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5666
Practice Address - Country:US
Practice Address - Phone:925-846-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADU0327481223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223P0221XDental ProvidersDentistPediatric Dentistry