Provider Demographics
NPI:1962432922
Name:BELLORINI, STEPHEN J (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:BELLORINI
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 1:11 BAYSTATE CT
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631
Mailing Address - Country:US
Mailing Address - Phone:508-255-0111
Mailing Address - Fax:508-255-1160
Practice Address - Street 1:11 BAYSTATE CT
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631
Practice Address - Country:US
Practice Address - Phone:508-255-0111
Practice Address - Fax:508-255-1160
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22060122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA22060OtherMASS HEALTH