Provider Demographics
NPI:1164583316
Name:CARAVANO, JOSEPH R (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:CARAVANO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 ROUTE 10 W
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2141
Mailing Address - Country:US
Mailing Address - Phone:973-361-1198
Mailing Address - Fax:
Practice Address - Street 1:390 ROUTE 10 WEST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NE
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-361-1198
Practice Address - Fax:973-361-3221
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ230471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice