Provider Demographics
NPI:1558780445
Name:MARCIANO, YEHUDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:YEHUDA
Middle Name:
Last Name:MARCIANO
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 1:211 HARBORVIEW S
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1909
Mailing Address - Country:US
Mailing Address - Phone:443-478-4379
Mailing Address - Fax:
Practice Address - Street 1:390 BERRY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-6084
Practice Address - Country:US
Practice Address - Phone:718-218-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2017-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0584871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry