MEDICARE: DR. MICHELLE GIUMENTA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	045916	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265495634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE GIUMENTA DDS

Provider Business Mailing Address
First Line	:	2530 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2220
Country	:	US
Telephone Number	:	718-979-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2530 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2220
Country	:	US
Telephone Number	:	718-979-6462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	07/08/2007

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