Provider Demographics
NPI:1053520585
Name:STEIN, BENJAMIN SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:SCOTT
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 1:18181 BUTTERFIELD BLVD #165
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037
Mailing Address - Country:US
Mailing Address - Phone:408-779-6444
Mailing Address - Fax:408-779-1484
Practice Address - Street 1:18181 BUTTERFIELD BLVD #165
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037
Practice Address - Country:US
Practice Address - Phone:408-779-6444
Practice Address - Fax:408-779-1484
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA77-0314732OtherTAX ID NUMBER