Provider Demographics
NPI:1851563050
Name:STERN, SHELDON JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:JEFFREY
Last Name:STERN
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 1:65 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002
Mailing Address - Country:US
Mailing Address - Phone:212-254-2225
Mailing Address - Fax:212-254-1473
Practice Address - Street 1:65 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002
Practice Address - Country:US
Practice Address - Phone:212-254-2225
Practice Address - Fax:212-254-1473
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0382101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00831181Medicaid