Provider Demographics
NPI:1487721650
Name:WEITH, STEVEN J (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:WEITH
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 1:375 JACKSON STREET
Mailing Address - Street 2:UNIT 200
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101
Mailing Address - Country:US
Mailing Address - Phone:651-222-0983
Mailing Address - Fax:651-265-8036
Practice Address - Street 1:375 JACKSON STREET UNIT 200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101
Practice Address - Country:US
Practice Address - Phone:651-222-0983
Practice Address - Fax:651-265-8036
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD87411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice