Stacy Wedin-Sandkuhl, DDS

Dentist, General Practice in Deer Park, NY. Individual provider (NPI-1).

NPI number1396920005

StatusActive

Last updated in NPPESJan 2, 2008

Details

NPI: 1396920005
Entity type: Individual (NPI-1)
Name: Mrs. Stacy Wedin-Sandkuhl
Credential: DDS
Sex: Female
Sole proprietor: No
Enumeration date: Jan 2, 2008
Last updated: Jan 2, 2008

Medicare and OIG

Medicare enrolled (PECOS): Yes · ORDER AND REFERRING ONLY - ORAL SURGERY
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
1223G0001X	Dentist, General Practice	047488-1	NY	Yes

Practice location

450 Grand Blvd
Deer Park, NY 11729-4243

Phone 631-667-4080 · Fax 631-667-4261

Mailing address

450 Grand Blvd
Deer Park, NY 11729-4243

Phone 631-667-4080 · Fax 631-667-4261

Is something wrong?

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Other General Practice Dentistry providers in Deer Park, NY

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