Individual provider Active NPI

Albert E Stofko, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Scranton, PA
National Provider Identifier
1255371852
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS017892L Issued in PA
Practice address
Suite 205
401 Adams Avenue
Scranton, PA 18510-2025
Phone
(570) 344-6464
Fax
(570) 344-0999
NPI assigned
Jun 8, 2006
Last updated
Dec 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS017892L PA Primary

Addresses

Primary practice location

Suite 205
401 Adams Avenue
Scranton, PA 18510-2025

Mailing address

Suite 205
401 Adams Avenue
Scranton, PA 18510-2025
Phone (570) 344-6464

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

LicenseStateTypeSpecialty
DS017892LPAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1255371852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUITE 205",
            "address_2": "401 ADAMS AVENUE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102025",
            "telephone_number": "570-344-6464",
            "fax_number": "570-344-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 205",
            "address_2": "401 ADAMS AVENUE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102025",
            "telephone_number": "570-344-6464",
            "fax_number": "570-344-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOFKO",
        "first_name": "ALBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS017892L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.