Healthcare Provider Details

I. General information

NPI: 1952935066
Provider Name (Legal Business Name): LAUREN STEPHENS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 E 63RD ST APT 110
NEW YORK NY
10065-7453
US

IV. Provider business mailing address

245 E 63RD ST APT 110
NEW YORK NY
10065-7453
US

V. Phone/Fax

Practice location:
  • Phone: 212-838-6226
  • Fax:
Mailing address:
  • Phone: 212-838-6226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number062266
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: