Provider Demographics
NPI:1336114255
Name:STEIN, DEAN LOREN (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:LOREN
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W THOMAS RD # 301
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4407
Mailing Address - Country:US
Mailing Address - Phone:602-406-3541
Mailing Address - Fax:602-067-1354
Practice Address - Street 1:350 W THOMAS RD
Practice Address - Street 2:SURGICAL SUITE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-406-3541
Practice Address - Fax:602-406-7135
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2023-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16846207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ268286Medicaid
050074475OtherMEDICARE RAILROAD
AZZ05WCHKJ46Medicare PIN
D44541Medicare UPIN