Provider Demographics
NPI:1235215617
Name:BROWNSTEIN, SIDNEY NMN (DDS)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:NMN
Last Name:BROWNSTEIN
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 1:2337 27TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1921
Mailing Address - Country:US
Mailing Address - Phone:310-450-3844
Mailing Address - Fax:
Practice Address - Street 1:1304 15TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1809
Practice Address - Country:US
Practice Address - Phone:310-450-3844
Practice Address - Fax:310-399-1236
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA234831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice