Provider Demographics
NPI:1922132299
Name:STEPHEN M. YOVINO, D.M.D.
Entity Type:Organization
Organization Name:STEPHEN M. YOVINO, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:YOVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-946-5060
Mailing Address - Street 1:901 VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6363
Mailing Address - Country:US
Mailing Address - Phone:814-946-5060
Mailing Address - Fax:814-946-4898
Practice Address - Street 1:901 VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-6363
Practice Address - Country:US
Practice Address - Phone:814-946-5060
Practice Address - Fax:814-946-4898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017056L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1813763OtherUNITED CONCORDIA
PA1813763OtherBLUE SHIELD