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General NPI Number Information
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NPI Number | 1497988752
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Entity Type | Individual
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Provider Name | JOSEPH FRANK DIBERNARDO DDS
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Gender | Male
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 79 LANDING AVE STE 1
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City | SMITHTOWN
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State | NY
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Zip | 11787-2748
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Country | US
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Telephone | 631-256-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 79 LANDING AVE STE 1
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City | SMITHTOWN
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State | NY
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Zip | 11787-2748
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Country | US
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Telephone | 516-446-7414
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Fax | 631-863-2627
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 051799
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License Number State | NY
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