Provider Demographics
NPI:1649276635
Name:SHEINBERG, STEPHEN (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SHEINBERG
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 1:1770 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5524
Mailing Address - Country:US
Mailing Address - Phone:718-901-8110
Mailing Address - Fax:718-901-8121
Practice Address - Street 1:1770 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5524
Practice Address - Country:US
Practice Address - Phone:718-901-8110
Practice Address - Fax:718-901-8121
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031060-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics