Provider Demographics
NPI:1265545529
Name:HIETANEN, STEVEN J (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:HIETANEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 FAIRGROUNDS RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-3007
Mailing Address - Country:US
Mailing Address - Phone:716-646-9185
Mailing Address - Fax:
Practice Address - Street 1:4031 LEGION DR
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4507
Practice Address - Country:US
Practice Address - Phone:716-648-1461
Practice Address - Fax:716-312-0036
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0415501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics