Provider Demographics
NPI:1710053285
Name:HUBER, STEPHEN JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOHN
Last Name:HUBER
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 1:4901 W 136TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-5926
Mailing Address - Country:US
Mailing Address - Phone:913-469-8884
Mailing Address - Fax:
Practice Address - Street 1:4901 W 136TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-5926
Practice Address - Country:US
Practice Address - Phone:913-469-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS603971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice