Provider Demographics
NPI:1376987867
Name:D'ADDARIO, ANTHONY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:D'ADDARIO
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 1:28202 CABOT RD
Mailing Address - Street 2:#460
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1222
Mailing Address - Country:US
Mailing Address - Phone:949-364-5300
Mailing Address - Fax:
Practice Address - Street 1:28202 CABOT RD
Practice Address - Street 2:#460
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1222
Practice Address - Country:US
Practice Address - Phone:949-364-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice