Provider Demographics
NPI:1801318829
Name:STEVENOT, LAUREN ANGELINA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ANGELINA
Last Name:STEVENOT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:ANGELINA
Other - Last Name:DULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1100 BONNELL ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215
Mailing Address - Country:US
Mailing Address - Phone:513-563-6936
Mailing Address - Fax:513-563-1008
Practice Address - Street 1:1100 BONNELL ST
Practice Address - Street 2:
Practice Address - City:CICINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215
Practice Address - Country:US
Practice Address - Phone:513-563-6936
Practice Address - Fax:513-563-1008
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0250341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice