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General NPI Number Information
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NPI Number | 1720004344
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Entity Type | Organization
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Legal Business Name | DR JOHN R VIVIANI DDS, P.C.
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 44 GREEN ST
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City | HUNTINGTON
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State | NY
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Zip | 11743-3393
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Country | US
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Telephone | 631-424-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 44 GREEN ST
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City | HUNTINGTON
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State | NY
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Zip | 11743-3393
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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 | OWNER
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Name | DR. JOHN RONALD VIVIANI
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Credential | DDS
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Telephone | 631-424-3838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 040407
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License Number State | NY
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