Healthcare Provider Details

I. General information

NPI: 1740336775
Provider Name (Legal Business Name): JOSEPH ANTHONY SALIERNO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 35TH ST
ASTORIA NY
11103-4701
US

IV. Provider business mailing address

39 EASTWOODS DR
COLD SPRING HARBOR NY
11724-2305
US

V. Phone/Fax

Practice location:
  • Phone: 718-278-0808
  • Fax: 718-278-1675
Mailing address:
  • Phone: 631-692-5431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number034198
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: