Provider Demographics
NPI:1730393638
Name:CAIN NIKODEM, STEFANIE LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:LYNN
Last Name:CAIN NIKODEM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4565 DRESSLER RD NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2549
Mailing Address - Country:US
Mailing Address - Phone:330-493-9457
Mailing Address - Fax:330-493-8898
Practice Address - Street 1:4565 DRESSLER RD NW
Practice Address - Street 2:SUITE 101
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2549
Practice Address - Country:US
Practice Address - Phone:330-493-9457
Practice Address - Fax:330-493-8898
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH212661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice