Provider Demographics
NPI:1316659683
Name:SIGAL, JOANNE MARIE (RDH)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARIE
Last Name:SIGAL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 44
Mailing Address - Street 2:UTOPIA PKWY
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365
Mailing Address - Country:US
Mailing Address - Phone:718-536-8509
Mailing Address - Fax:
Practice Address - Street 1:131 72
Practice Address - Street 2:40TH ROAD
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1135
Practice Address - Country:US
Practice Address - Phone:718-587-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024137-01124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist