Provider Demographics
NPI:1134386915
Name:SORKIN, STACEY K (DMD)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:K
Last Name:SORKIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 E BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2402
Mailing Address - Country:US
Mailing Address - Phone:410-848-6700
Mailing Address - Fax:410-848-4347
Practice Address - Street 1:518 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2402
Practice Address - Country:US
Practice Address - Phone:410-848-6700
Practice Address - Fax:410-848-4347
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics