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NPI Code Detail

MEDICARE: DR. ANTONELLA GIOVANNA RITA MAIETTA DMD

MEDICARE: DR. ANTONELLA GIOVANNA RITA MAIETTA DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist22DI02130500NJ
2122300000XDentistDI21305NJ

General Provider Information

NPI Number : 1407859069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTONELLA GIOVANNA RITA MAIETTA DMD
Provider Business Mailing Address
First Line : 105 HOBART PL
Second Line :
City : TOTOWA
State : NJ
Zip : 07512-2110
Country : US
Telephone Number : 973-943-9161
Fax Number : 973-471-3740
Provider Business Practice Location Address
First Line : 17 S WARREN ST
Second Line :
City : DOVER
State : NJ
Zip : 07801-4506
Country : US
Telephone Number : 973-328-3344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 02/04/2026

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