Active NPI
Elaine Dorothy Stefanowicz, DDS
- Dentist
- Phila, PA
National Provider Identifier
1194982231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS021690L
- Practice address
- 6904 Ridge Ave
Phila, PA 19128 - Phone
- (215) 483-8373
- Fax
- (215) 483-1510
- NPI assigned
- May 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS021690L | PA | Primary |
Addresses
Primary practice location
6904 Ridge Ave
Phila, PA 19128
Mailing address
6904 Ridge Ave
Phila, PA 19128
Phone (215) 483-8373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS021690L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1194982231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6904 RIDGE AVE",
"city": "PHILA",
"state": "PA",
"postal_code": "19128",
"telephone_number": "215-483-8373",
"fax_number": "215-483-1510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6904 RIDGE AVE",
"city": "PHILA",
"state": "PA",
"postal_code": "19128",
"telephone_number": "215-483-8373",
"fax_number": "215-483-1510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEFANOWICZ",
"first_name": "ELAINE",
"middle_name": "DOROTHY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-16",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS021690L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.