Provider Demographics
NPI:1528277738
Name:JOHN P. GRAZIANO DENTISTRY, PLLC
Entity type:Organization
Organization Name:JOHN P. GRAZIANO DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-833-0672
Mailing Address - Street 1:7501 FORT HAMILTON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2305
Mailing Address - Country:US
Mailing Address - Phone:718-833-0672
Mailing Address - Fax:718-833-6639
Practice Address - Street 1:7501 FORT HAMILTON PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2305
Practice Address - Country:US
Practice Address - Phone:718-833-0672
Practice Address - Fax:718-833-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030171DRJOHNGRAZIANO1223X0400X
NY0301711223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty