Provider Demographics
NPI:1598918922
Name:LERNER, SHELDON (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 E 14TH ST
Mailing Address - Street 2:SUITE 123
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1100
Mailing Address - Country:US
Mailing Address - Phone:718-376-9600
Mailing Address - Fax:
Practice Address - Street 1:1636 E 14TH ST
Practice Address - Street 2:SUITE 123
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1100
Practice Address - Country:US
Practice Address - Phone:718-376-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0382901223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics