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General NPI Number Information
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NPI Number | 1518196039
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Entity Type | Individual
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Provider Name | SCOTT ANTHONY PASIETA DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 9191 R G SKINNER PKWY UNIT 404
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9659
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Country | US
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Telephone | 904-443-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 9191 R G SKINNER PKWY UNIT 404
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9659
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Country | US
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Telephone | 904-443-7000
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DT-2589
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 14541
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN28662
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License Number State | FL
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