Provider Demographics
NPI:1316295231
Name:BREIG, JOSEPH JAMES (DMD ENDODONTIST)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAMES
Last Name:BREIG
Suffix:
Gender:M
Credentials:DMD ENDODONTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 W SAN LUIS ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8020
Mailing Address - Country:US
Mailing Address - Phone:561-827-3009
Mailing Address - Fax:
Practice Address - Street 1:13146 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7410
Practice Address - Country:US
Practice Address - Phone:915-742-5935
Practice Address - Fax:915-742-5174
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0392921223G0001X
TX284141223G0001X
FLDN200681223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice