Individual provider Active NPI

William Stern, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1184761769
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31359 Issued in NY
Practice address
1607 55TH St
Brooklyn, NY 11204-1824
Phone
(718) 851-0700
Fax
(718) 851-5715
NPI assigned
Jan 31, 2007
Last updated
Jun 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31359 NY Primary

Addresses

Primary practice location

1607 55TH St
Brooklyn, NY 11204-1824

Mailing address

1607 55TH St
Brooklyn, NY 11204-1824
Phone (718) 851-0700

Other identifiers 1

IdentifierTypeStateIssuer
00994110MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20150331002045 NY Practitioner - Oral Surgery 4587981519 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31359NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Assistance Resources & Extended Services Inc CurrentSince Dec 1, 2014 Accepting new patients

Locations

465 Grand St
New York, NY 10002
Phone (212) 420-1970

465 Grand St
Fl 3
New York, NY 10002
Phone (212) 420-1999

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1184761769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041824",
            "telephone_number": "718-851-0700",
            "fax_number": "718-851-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041824",
            "telephone_number": "718-851-0700",
            "fax_number": "718-851-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "WILLIAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "31359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00994110",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.