=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508844655
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANK MICHAEL CIANCI DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2006
-----------------------------------------------------
Last Update Date | 11/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11524 PARKCREST DR
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76207-5705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-885-4563
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1278 JUSTIN RD SUITE 108
-----------------------------------------------------
City | LEWISVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75077-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-317-1581
-----------------------------------------------------
Fax | 972-317-4836
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DS021545L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------