Provider Demographics
NPI:1003804782
Name:FALCIANO, ANTHONY LOUIS (DDS MAGD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LOUIS
Last Name:FALCIANO
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 WEIDNER AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2828
Mailing Address - Country:US
Mailing Address - Phone:516-764-7995
Mailing Address - Fax:516-255-0963
Practice Address - Street 1:3306 WEIDNER AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2828
Practice Address - Country:US
Practice Address - Phone:516-764-7995
Practice Address - Fax:516-255-0963
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039757122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist