Provider Demographics
NPI:1114920964
Name:GEIERMANN, STEVEN PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PATRICK
Last Name:GEIERMANN
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 1:5218 N WINTHROP AVE
Mailing Address - Street 2:# 3N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2306
Mailing Address - Country:US
Mailing Address - Phone:773-271-5871
Mailing Address - Fax:312-886-3770
Practice Address - Street 1:5218 N WINTHROP AVE
Practice Address - Street 2:# 3N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2306
Practice Address - Country:US
Practice Address - Phone:773-271-5871
Practice Address - Fax:312-886-3770
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010134561223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health