Provider Demographics
NPI:1982620001
Name:STEVEN J. BRAZIS DDS, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:STEVEN J. BRAZIS DDS, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BRAZIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-731-5151
Mailing Address - Street 1:6966 SUNRISE BLVD # 264
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-3144
Mailing Address - Country:US
Mailing Address - Phone:916-731-5151
Mailing Address - Fax:916-731-8743
Practice Address - Street 1:5030 J ST STE 302
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3800
Practice Address - Country:US
Practice Address - Phone:916-731-5151
Practice Address - Fax:916-731-8743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty