Provider Demographics
NPI:1568663011
Name:REGENSTEIN, STEVEN MARC (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARC
Last Name:REGENSTEIN
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 1:18 TANNERY LANE SOUTH
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883
Mailing Address - Country:US
Mailing Address - Phone:203-227-6376
Mailing Address - Fax:203-227-4045
Practice Address - Street 1:251 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880
Practice Address - Country:US
Practice Address - Phone:203-227-3421
Practice Address - Fax:203-226-9817
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0083131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice