Provider Demographics
NPI:1740404508
Name:STEADMAN, ROBERT KEMPTON (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KEMPTON
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W 5TH AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2823
Mailing Address - Country:US
Mailing Address - Phone:509-838-5447
Mailing Address - Fax:509-455-3727
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-838-5447
Practice Address - Fax:509-455-3727
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000045471223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5032305Medicaid
WA5820OtherDELTA - WA DENTAL SVC
WA26515OtherLABOR &INDUSTRIES
WAT02397Medicare UPIN
WA26515OtherLABOR &INDUSTRIES