Healthcare Provider Details

I. General information

NPI: 1639512775
Provider Name (Legal Business Name): ANTHONY L SCIORTINO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 N HAMILTON RD
COLUMBUS OH
43230-3760
US

IV. Provider business mailing address

4375 W DUBLIN GRANVILLE RD
DUBLIN OH
43017-2041
US

V. Phone/Fax

Practice location:
  • Phone: 614-475-5439
  • Fax:
Mailing address:
  • Phone: 914-494-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30.027111
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: