Provider Demographics
NPI:1811121510
Name:TIGANI, STEPHEN PHILLIP (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PHILLIP
Last Name:TIGANI
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 1:4545 42ND STREET, NW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-362-0070
Mailing Address - Fax:202-362-0072
Practice Address - Street 1:4545 42ND STREET, NW
Practice Address - Street 2:SUITE 102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-362-0070
Practice Address - Fax:202-362-0072
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC54461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics