Individual provider Active NPI

Sylvan S Stern, DDS

  • General Practice Dentistry
  • Southfield, MI
National Provider Identifier
1821149246
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12882 Issued in MI
Practice address
17040 W 12 Mile Rd
#150
Southfield, MI 48076-2131
Phone
(248) 559-0995
Fax
(248) 559-6724
NPI assigned
Jan 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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 12882 MI Primary

Addresses

Primary practice location

17040 W 12 Mile Rd
#150
Southfield, MI 48076-2131

Mailing address

14720 Loretta PL
Oak Park, MI 48237-1016
Phone (248) 559-0995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120207000442 MI Practitioner - Oral Surgery 6709043524 Practice locations: Southfield, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12882MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sylvan Stern Dental Sleep Medicine PLC PastSince Dec 3, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1821149246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14720 LORETTA PL",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371016",
            "telephone_number": "248-559-0995",
            "fax_number": "248-559-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17040 W 12 MILE RD",
            "address_2": "#150",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762131",
            "telephone_number": "248-559-0995",
            "fax_number": "248-559-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "SYLVAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.