Provider Demographics
NPI:1407838915
Name:VANDENBURGH, STEVEN L (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:VANDENBURGH
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 1:3036 BEARD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3442
Mailing Address - Country:US
Mailing Address - Phone:707-226-8800
Mailing Address - Fax:707-226-1343
Practice Address - Street 1:3036 BEARD RD
Practice Address - Street 2:SUITE B
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3442
Practice Address - Country:US
Practice Address - Phone:707-226-8800
Practice Address - Fax:707-226-1343
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37300122300000X
IDD3145122300000X
CO7786122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist