Provider Demographics
NPI:1275188674
Name:STEPHENS, ZACHARY REED (DDS)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:REED
Last Name:STEPHENS
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 1:2510 RIVER LILLY DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2263
Mailing Address - Country:US
Mailing Address - Phone:713-823-7042
Mailing Address - Fax:
Practice Address - Street 1:205 E HOUSTON ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4511
Practice Address - Country:US
Practice Address - Phone:281-592-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-03
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX355321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice