Provider Demographics
NPI:1720965585
Name:STETSKIV, MYKOLA (DMD)
Entity type:Individual
Prefix:
First Name:MYKOLA
Middle Name:
Last Name:STETSKIV
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 1:6228 S PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3938
Mailing Address - Country:US
Mailing Address - Phone:440-840-6170
Mailing Address - Fax:
Practice Address - Street 1:3684A DRESSLER RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2781
Practice Address - Country:US
Practice Address - Phone:330-452-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.028191122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist