Provider Demographics
NPI:1063770808
Name:HOWENSTEIN, JEFFREY LAWRENCE (DMD, MS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LAWRENCE
Last Name:HOWENSTEIN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 RED CEDAR CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:SD
Mailing Address - Zip Code:57038-6898
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:711 N SIOUX POINT RD
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5099
Practice Address - Country:US
Practice Address - Phone:605-242-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IADDS-090731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program