Provider Demographics
NPI:1144359555
Name:SEPANIAC, GREGORY JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JAMES
Last Name:SEPANIAC
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 1:575 DORSEYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1524
Mailing Address - Country:US
Mailing Address - Phone:412-967-9172
Mailing Address - Fax:
Practice Address - Street 1:575 DORSEYVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1524
Practice Address - Country:US
Practice Address - Phone:412-967-9172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021035L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice