Stephanie Solberg, D.D.S.
Individual provider Active NPI Dentist · Irving, NY
NPI 1881089340 · NPPES record last updated May 22, 2019
Key facts
- NPI
- 1881089340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 058979 (NY)
- Practice address
- 36 Thomas Indian School Dr
Irving, NY 14081-9300 - Phone
- (716) 532-0165
- NPI assigned
- Apr 1, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170503000021 | NY | Order and Referring Only - Dentist |
0749567675 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.24804 | OH | MD | General Practice Dentistry |
| 058979 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Nation of Indians | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.24804 | OH | |
| Dentist | 122300000X | 058979 | NY | Yes |
Addresses
Primary practice location
36 Thomas Indian School Dr
Irving, NY 14081-9300
Mailing address
36 Thomas Indian School Dr
Irving, NY 14081-9300
Phone (716) 532-0165
Other providers in Irving, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.