Individual provider Active NPI

Karyn Lisa Stern, DMD

  • Endodontics
  • Worcester, MA
National Provider Identifier
1699974337
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
21853 Issued in MA
Practice address
255 Park Ave Ste 303
Worcester, MA 01609-1991
Phone
(508) 755-3636
Fax
(508) 791-7245
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 21853 MA Primary

Addresses

Primary practice location

255 Park Ave Ste 303
Worcester, MA 01609-1991

Mailing address

255 Park Ave Ste 303
Worcester, MA 01609-1991
Phone (508) 755-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150619000980 MA Order and Referring Only - DentistPractitioner - Dentist 3375854136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21853MAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1699974337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PARK AVE STE 303",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091991",
            "telephone_number": "508-755-3636",
            "fax_number": "508-791-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE STE 303",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091991",
            "telephone_number": "508-755-3636",
            "fax_number": "508-791-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "KARYN",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "21853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.