Healthcare Provider Details

I. General information

NPI: 1093459281
Provider Name (Legal Business Name): MOSES STERN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 OCEAN AVE STE 1
BROOKLYN NY
11230-7359
US

IV. Provider business mailing address

2080 OCEAN AVE STE 1
BROOKLYN NY
11230-7359
US

V. Phone/Fax

Practice location:
  • Phone: 212-969-0155
  • Fax:
Mailing address:
  • Phone: 718-676-5226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number062759
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: