Mark Steven Stein, DDS
Individual provider Active NPI Dentist · Freeport, PA
NPI 1679538136 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1679538136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS024238L (PA)
- Practice address
- 500 Franklin Street
Freeport, PA 16229-1218 - Phone
- (724) 295-5118
- Fax
- (724) 295-5119
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS024238L | PA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS024238L | PA | Yes |
Addresses
Primary practice location
500 Franklin Street
Freeport, PA 16229-1218
Mailing address
PO Box 147
Freeport, PA 16229
Phone (724) 295-5118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001009029 | Medicaid | PA |
Other providers in Freeport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.