Provider Demographics
NPI:1124424684
Name:VIVIANO, VIRGINIA FLORENCE (DDS)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:FLORENCE
Last Name:VIVIANO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 S WASHINGTON ST
Mailing Address - Street 2:APARTMENT B
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3907
Mailing Address - Country:US
Mailing Address - Phone:631-252-9647
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:DENTAL DEPARTMENT
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program