Provider Demographics
NPI:1407896681
Name:MAIO, JOSEPH SAMUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SAMUEL
Last Name:MAIO
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 1:11667 EUREKA WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-7916
Mailing Address - Country:US
Mailing Address - Phone:801-455-7105
Mailing Address - Fax:
Practice Address - Street 1:1909 W 4700 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-1105
Practice Address - Country:US
Practice Address - Phone:801-968-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9042122300000X
UT341237-9923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist