Provider Demographics
NPI:1497485841
Name:ROSENFELD, STEPHANIE JOY (DDS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOY
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:JOY
Other - Last Name:ROFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:17280 GOLDWIN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17280 GOLDWIN DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1963
Practice Address - Country:US
Practice Address - Phone:163-538-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist