Provider Demographics
NPI:1447377619
Name:VARLJEN, STEPHANIE R (DDS, PHD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:VARLJEN
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:R
Other - Last Name:TOMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 LOGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-3015
Mailing Address - Country:US
Mailing Address - Phone:814-946-1950
Mailing Address - Fax:814-946-5725
Practice Address - Street 1:712 S LOGAN BLVD
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-3032
Practice Address - Country:US
Practice Address - Phone:814-946-1950
Practice Address - Fax:814-946-5725
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035329-L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12957648687OtherGROUP NPI#
PA000563403OtherUCCI GRP PIN
PA1427192OtherUCCI PIN
PA000563403OtherUCCI GRP PIN