Ivan Fredric Stein, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15717 Issued in NJ

Practice address

769 Northfield Ave
Suite 154
West Orange, NJ 07052-1198

Phone

(973) 736-0111

Fax

(973) 325-6442

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Other, 1986

Medicare assignment

May accept Medicare assignment

Group practices

Northfield Dental GroupGroup PAC ID 3971782319, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northfield Dental Group

  • General Practice Dentistry
  • West Orange, NJ
  • NPI 1225134455
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083711469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE",
            "address_2": "SUITE 154",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-258-1905",
            "fax_number": "973-379-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE",
            "address_2": "SUITE 154",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521198",
            "telephone_number": "973-736-0111",
            "fax_number": "973-325-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "IVAN",
        "middle_name": "FREDRIC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "15717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steering Health
• Eugene Michael Stefanelli, EDS,PHD
• Leonard Stefanelli
• Andrew B Stefaniwsky, M.D.
• Allan Jeremy Stein, DMD
• Traci R. Stein, PHD, MPH
• Stephanie Badalamenti MD PHD
• Rosetta Stephens, LCSW
• Steven Hertz, MD,LLC
• STF Enterprise LLC

• General Practice Dentistry in West Orange, NJ
• Providers in West Orange, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.