Provider Demographics
NPI:1417200197
Name:SOTEREANOS, DONNA JANET (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:JANET
Last Name:SOTEREANOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALPHA DR
Mailing Address - Street 2:EAST
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2943
Mailing Address - Country:US
Mailing Address - Phone:412-435-0008
Mailing Address - Fax:
Practice Address - Street 1:1 ALPHA DR
Practice Address - Street 2:EAST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2943
Practice Address - Country:US
Practice Address - Phone:412-435-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028193L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist