Provider Demographics
NPI:1447267133
Name:STEFFEN, JAMES MICHAEL (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:STEFFEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:MICHAEL
Other - Last Name:STEFFEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:1601 S BOULEVARD ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5143
Mailing Address - Country:US
Mailing Address - Phone:405-341-2587
Mailing Address - Fax:405-340-0510
Practice Address - Street 1:1601 S BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5143
Practice Address - Country:US
Practice Address - Phone:405-341-2587
Practice Address - Fax:405-340-0510
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK36411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics