Provider Demographics
NPI:1063255842
Name:AIELLO, SALVATORE JOSEPH
Entity type:Individual
Prefix:
First Name:SALVATORE
Middle Name:JOSEPH
Last Name:AIELLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 INDEPENDENCE CIR STE B
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4963
Mailing Address - Country:US
Mailing Address - Phone:530-892-1218
Mailing Address - Fax:
Practice Address - Street 1:140 INDEPENDENCE CIR STE B
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4963
Practice Address - Country:US
Practice Address - Phone:530-892-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110135122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist