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NPI Code Detail

MEDICARE: DR. STEFANOS MATTHAIOS DDS, MSC

MEDICARE:  DR. STEFANOS  MATTHAIOS  DDS, MSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryRES.004425OH

General Provider Information

NPI Number : 1467273110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEFANOS MATTHAIOS DDS, MSC
Provider Business Mailing Address
First Line : 10001 CHESTER AVE APT 609
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1637
Country : US
Telephone Number : 216-333-6875
Fax Number :
Provider Business Practice Location Address
First Line : 10001 CHESTER AVE APT 609
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1637
Country : US
Telephone Number : 216-333-6875
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2024
Last Update Date : 10/24/2024

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Directions to “ DR. STEFANOS MATTHAIOS DDS, MSC” Practice Location

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