Provider Demographics
NPI:1225228422
Name:SCRIVANI, STEVEN JOHN (DDS, DMED)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOHN
Last Name:SCRIVANI
Suffix:
Gender:M
Credentials:DDS, DMED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE KNEELAND STREET
Mailing Address - Street 2:SUITE 601
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-3482
Mailing Address - Fax:
Practice Address - Street 1:ONE KNEELAND STREET
Practice Address - Street 2:SUITE 601
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-3482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA186771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery