Provider Demographics
NPI:1467856377
Name:DIPIERO FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:DIPIERO FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIPIERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-867-9494
Mailing Address - Street 1:1376 N PORTAGE PATH
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5848
Mailing Address - Country:US
Mailing Address - Phone:330-867-9494
Mailing Address - Fax:330-867-9492
Practice Address - Street 1:1376 N PORTAGE PATH
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5848
Practice Address - Country:US
Practice Address - Phone:330-867-9494
Practice Address - Fax:330-867-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0230331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty