Provider Demographics
NPI:1194999870
Name:MONDRE, STEVEN JULES (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JULES
Last Name:MONDRE
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 1:136 E 57TH ST
Mailing Address - Street 2:SUITE 1604
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2707
Mailing Address - Country:US
Mailing Address - Phone:212-752-8181
Mailing Address - Fax:212-752-8201
Practice Address - Street 1:136 E 57TH ST
Practice Address - Street 2:SUITE 1604
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2707
Practice Address - Country:US
Practice Address - Phone:212-752-8181
Practice Address - Fax:212-752-8201
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist