Provider Demographics
NPI:1447320312
Name:STEIN, ALAN ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROBERT
Last Name:STEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18531 ROSCOE BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4641
Mailing Address - Country:US
Mailing Address - Phone:818-772-1280
Mailing Address - Fax:818-772-6546
Practice Address - Street 1:18531 ROSCOE BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4641
Practice Address - Country:US
Practice Address - Phone:818-772-1280
Practice Address - Fax:818-772-6546
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist