Healthcare Provider Details

I. General information

NPI: 1568422871
Provider Name (Legal Business Name): JOSEPH N. D'ANIELLO D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11050 N SAGUARO BLVD
FOUNTAIN HILLS AZ
85268-5549
US

IV. Provider business mailing address

14850 E GRANDVIEW DR UNIT 250
FOUNTAIN HILLS AZ
85268-3341
US

V. Phone/Fax

Practice location:
  • Phone: 480-837-1315
  • Fax:
Mailing address:
  • Phone: 520-256-8486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number5332
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: