Provider Demographics
NPI:1285633701
Name:HUTCHESON, STEPHEN LLOYD (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LLOYD
Last Name:HUTCHESON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4004
Mailing Address - Country:US
Mailing Address - Phone:740-654-8445
Mailing Address - Fax:740-654-2841
Practice Address - Street 1:1320 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4004
Practice Address - Country:US
Practice Address - Phone:740-654-8445
Practice Address - Fax:740-654-2841
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30014451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0248708Medicaid
OHTRIGONOtherTRIGON INS
OH14495OtherDELTA DENTAL INS
OH141485OtherSUPERIOR DENTAL INS
OH31085252400OtherBWC
OH594533OtherUNITED CONCORDIA
OH3001445OtherLICENSE
OH3001445OtherLICENSE