Provider Demographics
NPI:1598787343
Name:SIRAGUSA II, JOSEPH J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:SIRAGUSA II
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2114 HARTFORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2409
Mailing Address - Country:US
Mailing Address - Phone:757-826-3636
Mailing Address - Fax:757-826-1316
Practice Address - Street 1:2114 HARTFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2409
Practice Address - Country:US
Practice Address - Phone:757-826-3636
Practice Address - Fax:757-826-1316
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014101111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice