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NPI Code Detail

MEDICARE: JOANN DIANJOELL RDH

MEDICARE:   JOANN  DIANJOELL  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
1124Q00000XDental Hygienist22HI01051600NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122HI01051600OTHERNJLICENSE

General Provider Information

NPI Number : 1912472432
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANN DIANJOELL RDH
Provider Business Mailing Address
First Line : 53 S LAUREL ST
Second Line :
City : BRIDGETON
State : NJ
Zip : 08302-1946
Country : US
Telephone Number : 856-451-4700
Fax Number : 856-575-0818
Provider Business Practice Location Address
First Line : 3700 NEW JERSEY AVE
Second Line :
City : WILDWOOD
State : NJ
Zip : 08260-6154
Country : US
Telephone Number : 856-451-4700
Fax Number : 856-575-0818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2018
Last Update Date : 10/11/2018

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