Healthcare Provider Details

I. General information

NPI: 1659264190
Provider Name (Legal Business Name): KUPNIEWSKI DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 W 38TH ST
ERIE PA
16506-4564
US

IV. Provider business mailing address

2266 PINNACLE CT
ERIE PA
16506-6438
US

V. Phone/Fax

Practice location:
  • Phone: 814-835-8300
  • Fax: 814-833-2890
Mailing address:
  • Phone: 814-872-5057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN D KUPNIEWSKI
Title or Position: OWNER
Credential: DMD
Phone: 814-873-5057