Provider Demographics
NPI:1508889387
Name:SIERAKOWSKI, STEVEN R (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:SIERAKOWSKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 WILMINGTON W CHESTER PIKE STE 100B
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-8198
Mailing Address - Country:US
Mailing Address - Phone:610-558-8283
Mailing Address - Fax:610-558-9868
Practice Address - Street 1:1786 WILMINGTON W CHESTER PIKE STE 100B
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-8198
Practice Address - Country:US
Practice Address - Phone:610-558-8283
Practice Address - Fax:610-558-9868
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023004001223P0300X
DEG1-00012841223P0300X
PADS0360121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics