MEDICARE: ALLYSON VIVENTI

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
1	124Q00000X	Dental Hygienist	22HI00931700	NJ

General Provider Information

NPI Number	:	1861342370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON VIVENTI

Provider Business Mailing Address
First Line	:	203 W GLENCOVE AVE
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1707
Country	:	US
Telephone Number	:	973-670-9216
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 W GLENCOVE AVE
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1707
Country	:	US
Telephone Number	:	973-670-9216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ ALLYSON VIVENTI ” Practice Location

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