Healthcare Provider Details

I. General information

NPI: 1700606019
Provider Name (Legal Business Name): ALEXANDRA CAITLIN STEIN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 E 72ND ST APT 5J
NEW YORK NY
10021-4653
US

IV. Provider business mailing address

399 E 72ND ST APT 5J
NEW YORK NY
10021-4653
US

V. Phone/Fax

Practice location:
  • Phone: 917-579-8129
  • Fax:
Mailing address:
  • Phone: 917-579-8129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI03042500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: