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STEPHENS DENTAL
NPI 1134058738
Dentist - General Practice in San Diego, CA

Active since May 18, 2026
3588 4TH AVE STE 300, SAN DIEGO, CA 92103(619) 497-0122(619) 497-0264 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stephens Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHENS DENTAL (NPI 1134058738) is a healthcare organization registered as a general practice in San Diego, California and active in the NPI registry since May 2026. The organization lists Jaylord Medallon, Manager, as its authorized official.

NPPES Registry Identity

NPI1134058738
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSTEPHENS DENTAL
Location Address3588 4TH AVE STE 300San Diego, CA 92103-4947
Mailing Address3588 4th Ave Ste 300San Diego, CA 92103-4947 · (619) 497-0122 · Fax (619) 497-0264
Phone(619) 497-0122
Fax(619) 497-0264
Organization SubpartNo
Authorized OfficialJaylord MedallonManager · (619) 497-0122
Enumeration DateMay 18, 2026
NPPES CertifiedMay 18, 2026
✔ NPI 1134058738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3588 4TH AVE STE 300, San Diego, CA 92103
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BITA TAHVILDARI
Dentist
3588 4TH AVE STE 300
SAN DIEGO, CA 92103
San Diego County (619) 295-5261

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephens Dental's NPI number?

The NPI number for Stephens Dental is 1134058738. It was assigned to this organization in the NPPES registry on May 18, 2026.

Where is Stephens Dental located?

Stephens Dental is located at 3588 4th Ave Ste 300, San Diego, CA 92103. The listed phone number is (619) 497-0122.

What is Stephens Dental's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Stephens Dental was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.