Provider Demographics
NPI:1376084004
Name:FILIP, STEFAN (DDS)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:
Last Name:FILIP
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 1:237 MAIN ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3139
Mailing Address - Country:US
Mailing Address - Phone:626-274-7687
Mailing Address - Fax:
Practice Address - Street 1:2740 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7002
Practice Address - Country:US
Practice Address - Phone:310-534-3002
Practice Address - Fax:310-534-3017
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100882122300000X
MADN1857694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist