Provider Demographics
NPI:1437244373
Name:STOFKO, JOSEPH ALBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:STOFKO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5351 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9651
Mailing Address - Country:US
Mailing Address - Phone:724-443-5300
Mailing Address - Fax:724-443-0215
Practice Address - Street 1:5351 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9651
Practice Address - Country:US
Practice Address - Phone:724-443-5300
Practice Address - Fax:724-443-0215
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-029160-L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103364323-0001Medicaid