Provider Demographics
NPI:1427040039
Name:SACCOGNA, JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SACCOGNA
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 1:1490 S WATER ST
Mailing Address - Street 2:UNIVERSITY PLAZA
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3848
Mailing Address - Country:US
Mailing Address - Phone:330-673-9129
Mailing Address - Fax:330-673-9305
Practice Address - Street 1:1490 S WATER ST
Practice Address - Street 2:UNIVERSITY PLAZA
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3848
Practice Address - Country:US
Practice Address - Phone:330-673-9129
Practice Address - Fax:330-673-9305
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12557208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice