Provider Demographics
NPI:1386423358
Name:PISANO UHRI, RAFFAELE (DDS)
Entity type:Individual
Prefix:DR
First Name:RAFFAELE
Middle Name:
Last Name:PISANO UHRI
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 1:839 NANDINA DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2408
Mailing Address - Country:US
Mailing Address - Phone:813-705-5097
Mailing Address - Fax:
Practice Address - Street 1:3116 MOUNT VERNON AVE # 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22305-2639
Practice Address - Country:US
Practice Address - Phone:703-584-5416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014183171223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics