Provider Demographics
NPI:1275510133
Name:CHIPRIANO, JOSEPH DOMINIC JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DOMINIC
Last Name:CHIPRIANO
Suffix:JR
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 1:2000 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-1917
Mailing Address - Country:US
Mailing Address - Phone:570-622-3437
Mailing Address - Fax:570-622-6350
Practice Address - Street 1:2000 W MARKET ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-1917
Practice Address - Country:US
Practice Address - Phone:570-622-3437
Practice Address - Fax:570-622-6350
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035105L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice