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Contact Information

STACIE D FENDERSON, DDS MS
8689 FOLSOM BLVD
SACRAMENTO, CA95826
 Phone: 916-381-7171
 Fax: 916-381-1171
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthodontics and Dentofacial Orthopedics

1223X0400X
Indicates primary specialty

NPI Profile & details for STACIE D FENDERSON · (Female)

NPI # 1053500959
Status Active
Credentials DDS MS
Entity Individual
Enumeration date 10/17/2007
Last updated 10/17/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 52724
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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