Organization Active NPI

Benjamin H Stein OD Inc

  • Optometrist
  • Southfield, MI
National Provider Identifier
1760640718
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BENJAMIN H STEIN OD INC
Practice address
21500 Northwestern Hwy
Suite #635
Southfield, MI 48075-5018
Phone
(248) 569-2025
Fax
(248) 569-5103
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Authorized official

Name
Mr. Stuart Alan Stein
Title
President/Sec. Treas.
Phone
(248) 569-2025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

21500 Northwestern Hwy
Suite #635
Southfield, MI 48075-5018

Mailing address

21500 Northwestern Hwy
Suite #635
Southfield, MI 48075-5018
Phone (248) 569-2025

Other identifiers 1

IdentifierTypeStateIssuer
004585433MedicaidMI

National Provider Directory

National Provider Directory

Locations

21500 Northwestern Hwy
#635
Southfield, MI 48075
Phone (248) 569-2025

21500 Northwestern Hwy
#63
Southfield, MI 48075
Phone (248) 569-2025

21500 Northwestern Hwy
Ste 635
Southfield, MI 48075
Phone (248) 569-2025

29911 Northwestern Hwy
Southfield, MI 48034
Phone (248) 569-2025

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1760640718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21500 NORTHWESTERN HWY",
            "address_2": "SUITE #635",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755018",
            "telephone_number": "248-569-2025",
            "fax_number": "248-569-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21500 NORTHWESTERN HWY",
            "address_2": "SUITE #635",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755018",
            "telephone_number": "248-569-2025",
            "fax_number": "248-569-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN H STEIN OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT/SEC. TREAS.",
        "authorized_official_telephone_number": "248-569-2025",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004585433",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.