Provider Demographics
NPI:1003030081
Name:FERRIOLA, JEANNINE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEANNINE
Middle Name:M
Last Name:FERRIOLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5622
Mailing Address - Country:US
Mailing Address - Phone:718-236-0769
Mailing Address - Fax:718-975-0323
Practice Address - Street 1:1701 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5622
Practice Address - Country:US
Practice Address - Phone:718-236-0769
Practice Address - Fax:718-975-0323
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0430121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice