Provider Demographics
NPI:1962949859
Name:JOSEPH DEBIASE DDS PLLC
Entity type:Organization
Organization Name:JOSEPH DEBIASE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DEBIASE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-908-4939
Mailing Address - Street 1:711 LINDA AVE
Mailing Address - Street 2:
Mailing Address - City:THORNWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10594-1534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 304A
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1526
Practice Address - Country:US
Practice Address - Phone:914-908-4939
Practice Address - Fax:914-968-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056765261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental