Provider Demographics
NPI:1891508412
Name:CATALANO PIVEC, STEPHANIE ANDREA (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANDREA
Last Name:CATALANO PIVEC
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BISHOP GATE LN APT 1417
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4177
Mailing Address - Country:US
Mailing Address - Phone:786-792-4142
Mailing Address - Fax:
Practice Address - Street 1:630 ATLANTIC BLVD STE 7
Practice Address - Street 2:
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-4001
Practice Address - Country:US
Practice Address - Phone:904-247-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN31010122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist