Provider Demographics
NPI:1922241025
Name:HOFFMAN, STACY LOUISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:LOUISE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LOUISE
Other - Last Name:PIATKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6932 WILLIAMS RD
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304
Mailing Address - Country:US
Mailing Address - Phone:716-297-1675
Mailing Address - Fax:716-297-1676
Practice Address - Street 1:6932 WILLIAMS RD
Practice Address - Street 2:SUITE 1900
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304
Practice Address - Country:US
Practice Address - Phone:716-297-1675
Practice Address - Fax:716-297-1676
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0549571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03308409Medicaid