Provider Demographics
NPI:1912036724
Name:STEARN, MITCHELL H (DDS)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:H
Last Name:STEARN
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 1:770 FULTON ST
Mailing Address - Street 2:SENSOCARE DENTAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1545
Mailing Address - Country:US
Mailing Address - Phone:718-638-0600
Mailing Address - Fax:718-638-6842
Practice Address - Street 1:770 FULTON ST
Practice Address - Street 2:SENSOCARE DENTAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1545
Practice Address - Country:US
Practice Address - Phone:718-638-0600
Practice Address - Fax:718-638-6842
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038529511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00875021Medicaid