Provider Demographics
NPI:1699086751
Name:ESTEP, JASON RYAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:RYAN
Last Name:ESTEP
Suffix:
Gender:
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:POPLARVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39470-0073
Mailing Address - Country:US
Mailing Address - Phone:601-795-8024
Mailing Address - Fax:
Practice Address - Street 1:2113 GOVERNMENT ST
Practice Address - Street 2:STE K1
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3954
Practice Address - Country:US
Practice Address - Phone:228-806-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3549-101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice