Steven Paul Engebretson, DMD, MS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

046334 Issued in NY

Practice address

630 5TH Ave
Suite 1860
New York, NY 10111-0100

Phone

(212) 765-7340

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1265563589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLY LN",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331611",
            "telephone_number": "212-998-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 5TH AVE",
            "address_2": "SUITE 1860",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101110100",
            "telephone_number": "212-765-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEBRETSON",
        "first_name": "STEVEN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "046334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy PW Eng, MSW, LCSWR
• Winnie Eng, PH.D.
• Danielle Enga
• Ryan Engdahl
• Caitlin Enge, RDN, CDN
• Alexis Engel, MD
• Anelise Engel, M.D.,P.C.
• Connor Engel
• David Joel Engel, M.D.
• Harry M Engel, MD

• Periodontics in New York, NY
• Providers in New York, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.