MEDICARE: GINA MARIE VIANO RDH

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	124Q00000X	Dental Hygienist	DH075609	PA
2	124Q00000X	Dental Hygienist

General Provider Information

NPI Number	:	1316781131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MARIE VIANO RDH

Provider Business Mailing Address
First Line	:	8041 HUNTING VALLEY DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-8113
Country	:	US
Telephone Number	:	330-518-2059
Fax Number	:

Provider Business Practice Location Address
First Line	:	8041 HUNTING VALLEY DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-8113
Country	:	US
Telephone Number	:	330-518-2059
Fax Number	:

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

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	04/06/2026

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