Provider Demographics
NPI:1487030300
Name:STEFFENS, REBECCA (DMD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEFFENS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 TROTTERS FIELD WAY
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5277
Mailing Address - Country:US
Mailing Address - Phone:817-300-4208
Mailing Address - Fax:
Practice Address - Street 1:16160 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3338
Practice Address - Country:US
Practice Address - Phone:734-261-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101201223E0200X
TX312131223G0001X
MI29010221501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223E0200XDental ProvidersDentistEndodontics