Provider Demographics
NPI:1174528590
Name:MOICEANU, STEFAN (DDS)
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:
Last Name:MOICEANU
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 1:2970 HILLTOP MALL RD
Mailing Address - Street 2:STE 211
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1949
Mailing Address - Country:US
Mailing Address - Phone:510-758-7222
Mailing Address - Fax:510-758-7741
Practice Address - Street 1:2970 HILLTOP MALL RD
Practice Address - Street 2:STE 211
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1949
Practice Address - Country:US
Practice Address - Phone:510-758-7222
Practice Address - Fax:510-758-7741
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice