Provider Demographics
NPI:1356681597
Name:BRIGNONI, VIVIANA C (DMD)
Entity Type:Individual
Prefix:MRS
First Name:VIVIANA
Middle Name:C
Last Name:BRIGNONI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NORTH RD. SUITE C.
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930
Mailing Address - Country:US
Mailing Address - Phone:908-879-7709
Mailing Address - Fax:908-879-8367
Practice Address - Street 1:1961 MORRIS AVE STE B4
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3519
Practice Address - Country:US
Practice Address - Phone:908-686-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026252001223G0001X
NJ070011223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice