Provider Demographics
NPI:1154404622
Name:PISCIOTTA, DON J (DDS)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:J
Last Name:PISCIOTTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 GROVEDALE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANCONIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315
Mailing Address - Country:US
Mailing Address - Phone:703-313-0404
Mailing Address - Fax:703-313-6870
Practice Address - Street 1:6408 GROVEDALE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANCONIA
Practice Address - State:VA
Practice Address - Zip Code:22315
Practice Address - Country:US
Practice Address - Phone:703-313-0404
Practice Address - Fax:703-313-6870
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010061801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice