MEDICARE: DR. JOSEPH RINAGGIO D.D.S., M.S.

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry	22DI02115300	NJ
2	1223E0200X	Endodontics	22DI02115300	NJ

General Provider Information

NPI Number	:	1760441737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH RINAGGIO D.D.S., M.S.

Provider Business Mailing Address
First Line	:	110 BERGEN ST
Second Line	:	RUTGERS SCHOOL OF DENTAL MEDICINE, RM. D885
City	:	NEWARK
State	:	NJ
Zip	:	07103-2495
Country	:	US
Telephone Number	:	973-972-8909
Fax Number	:	973-972-3164

Provider Business Practice Location Address
First Line	:	110 BERGEN ST
Second Line	:	RUTGERS SCHOOL OF DENTAL MEDICINE, RM. D885
City	:	NEWARK
State	:	NJ
Zip	:	07103-2495
Country	:	US
Telephone Number	:	973-972-8909
Fax Number	:	973-972-3164

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	05/03/2016

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