Provider Demographics
NPI:1376631523
Name:NIRENSTEIN, JEFFRY (DDS)
Entity Type:Individual
Prefix:MR
First Name:JEFFRY
Middle Name:
Last Name:NIRENSTEIN
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 1:461 PARK AVE SOUTH
Mailing Address - Street 2:JEFFRY NIRENSTEIN DENTAL PC SUITE 800
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-532-7770
Mailing Address - Fax:212-532-7795
Practice Address - Street 1:2841 BRAGG STREET
Practice Address - Street 2:JEFFRY NIRENSTEIN DENTAL PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-769-2400
Practice Address - Fax:718-769-6222
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01763771Medicaid