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General NPI Number Information
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NPI Number | 1134189509
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Entity Type | Individual
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Provider Name | BRIAN RICHARD CIPORIN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6839 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7234
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Country | US
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Telephone | 718-497-4585
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Fax | 718-497-4585
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Provider Business Mailing Address
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Address Line | 8808 151ST AVE 5K
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City | HOWARD BEACH
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State | NY
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Zip | 11414-1440
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Country | US
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Telephone | 718-845-7193
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Fax | 718-845-7193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | NY039882
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401006644
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License Number State | VA
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