Provider Demographics
NPI:1275875254
Name:INDRIOLO, JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:INDRIOLO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 VETERANS RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4106
Mailing Address - Country:US
Mailing Address - Phone:914-962-5566
Mailing Address - Fax:914-962-6010
Practice Address - Street 1:206 VETERANS RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4106
Practice Address - Country:US
Practice Address - Phone:914-962-5566
Practice Address - Fax:914-962-6010
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0448161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice