Provider Demographics
NPI:1841873478
Name:STEFAN, SYMEON E (DDS)
Entity type:Individual
Prefix:
First Name:SYMEON
Middle Name:E
Last Name:STEFAN
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 1:26 BELDEN AVE UNIT 2126
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3384
Mailing Address - Country:US
Mailing Address - Phone:818-859-8360
Mailing Address - Fax:
Practice Address - Street 1:300 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-1142
Practice Address - Country:US
Practice Address - Phone:203-966-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT139451223G0001X
PADS0450701223G0001X
MEDEN4912122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist