Provider Demographics
NPI:1699950238
Name:DARRIN J. VIOLI, DMD, PSC
Entity type:Organization
Organization Name:DARRIN J. VIOLI, DMD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-633-4828
Mailing Address - Street 1:320 BOONE STATION RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8591
Mailing Address - Country:US
Mailing Address - Phone:502-633-4828
Mailing Address - Fax:502-633-7818
Practice Address - Street 1:320 BOONE STATION RD
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8591
Practice Address - Country:US
Practice Address - Phone:502-633-4828
Practice Address - Fax:502-633-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYH32355Medicare UPIN