Provider Demographics
NPI:1821824764
Name:OS DENTAL PLLC
Entity type:Organization
Organization Name:OS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-698-8000
Mailing Address - Street 1:2856 N GALLOWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4861
Mailing Address - Country:US
Mailing Address - Phone:972-698-8000
Mailing Address - Fax:
Practice Address - Street 1:2856 N GALLOWAY AVE
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4861
Practice Address - Country:US
Practice Address - Phone:972-698-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty