Provider Demographics
NPI:1073500849
Name:SCHWARTZ, STEVEN RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RICHARD
Last Name:SCHWARTZ
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 1:2844 OCEAN PKWY
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7900
Mailing Address - Country:US
Mailing Address - Phone:718-946-6600
Mailing Address - Fax:718-996-2261
Practice Address - Street 1:2844 OCEAN PKWY
Practice Address - Street 2:SUITE B-2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7900
Practice Address - Country:US
Practice Address - Phone:718-946-6600
Practice Address - Fax:718-996-2261
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0384431223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD1H941Medicare ID - Type Unspecified
NYE45025Medicare UPIN