Healthcare Provider Details

I. General information

NPI: 1609571819
Provider Name (Legal Business Name): DANIEL JOSEPH DEMAURO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 S MAIN ST
CENTRAL SQUARE NY
13036-9105
US

IV. Provider business mailing address

5000 BRITTANY LN
SYRACUSE NY
13215-1201
US

V. Phone/Fax

Practice location:
  • Phone: 315-668-6261
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number063951
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: