Provider Demographics
NPI:1689654519
Name:HESS, STEPHEN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:HESS
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 1:17508 K ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-2672
Mailing Address - Country:US
Mailing Address - Phone:402-933-9495
Mailing Address - Fax:
Practice Address - Street 1:2500 CALIFORNIA PLZ
Practice Address - Street 2:CREIGHTON UNIVERSITY DENTAL SCHOOL, ROOM 210
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68178-0001
Practice Address - Country:US
Practice Address - Phone:402-280-5642
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE48011223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098888Medicare ID - Type Unspecified