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General NPI Number Information
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NPI Number | 1346932613
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Entity Type | Individual
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Provider Name | TIANA PISCITELLI DMD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 3698 LARGENT WAY NW STE 201
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City | MARIETTA
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State | GA
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Zip | 30064-5923
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Country | US
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Telephone | 770-420-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 40 ROYAL OAK DR
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City | WEST HARTFORD
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State | CT
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Zip | 06107-3121
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 13839
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN123778.
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License Number State | GA
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