Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1700061371 Deactivated / Inactive NPI Male Practitioner

Dr. Stephen Nelson Jaffe , DDS

Dentist - General Practice • San Rafael, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Stephen Jaffe has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 02, 2008
NPI Deactivation Date September 25, 2025
Total Practice Duration ~17 Years of Practice (2008 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Stephen Jaffe, DDS was a registered Dentist - General Practice practicing in San Rafael, CA. Throughout an active medical career spanning 17 years, Dr. Jaffe provided care at the practice location at 1721 5TH AVE until profile deactivation on 2025-09-25.

Practice Location & Contact Primary Location

Practice Address

1721 5th Ave
Suite A

San Rafael, CA 949011820

Telephone 4154534720
Associated Practice Facility / Clinic
🏢 Tamal Vista Family Dentistry Facility NPI 1154999134

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in San Rafael, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
51 Specialists

Practicing in San Rafael, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 17943

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. James Mcdowell , DDS

Dentist - General Practice

NPI 1033316302

Doctor of Dental Surgery

NPI 1356780712

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 25, 2025

Record deactivated on September 25, 2025

NPI Profile Active January 02, 2008

NPI status registered as active in NPPES database

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Updated Practice Location January 02, 2008

Registered at 1721 5TH AVE, SUITE A, SAN RAFAEL, CA 949011820 (Tel: 4154534720)

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Updated Business Mailing Address January 02, 2008

Registered at 1721 5TH AVE, SUITE A, SAN RAFAEL, CA 949011820 (Tel: 4154534720)

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Provider Name / Credentials Updated January 02, 2008

Recorded as STEPHEN JAFFE, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 02, 2008

Dentist (License #17943 in CA)

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Initial NPI Registration & Enumeration January 02, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1700061371
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 02, 2008
Last Update: January 02, 2008
Deactivation Date: September 25, 2025

Mailing Address

1721 5th Ave, Suite A

San Rafael, CA 949011820

Phone: 4154534720

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.