Provider Demographics
NPI:1205011814
Name:BILELLO, RITAMARIE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:RITAMARIE
Middle Name:
Last Name:BILELLO
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 1:450 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4243
Mailing Address - Country:US
Mailing Address - Phone:631-667-4080
Mailing Address - Fax:631-667-4261
Practice Address - Street 1:450 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-4243
Practice Address - Country:US
Practice Address - Phone:631-667-4080
Practice Address - Fax:631-667-4261
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048613-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice