Provider Demographics
NPI:1396815650
Name:CIANCIOLA BEACH, JULIE ANN (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:CIANCIOLA BEACH
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 ELMRIDGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-3461
Mailing Address - Country:US
Mailing Address - Phone:585-326-8431
Mailing Address - Fax:585-486-3048
Practice Address - Street 1:368 ELMRIDGE CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3461
Practice Address - Country:US
Practice Address - Phone:585-326-8431
Practice Address - Fax:585-486-3048
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0471631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics