Provider Demographics
NPI:1629261896
Name:SICILIANO, ANTOINETTE (DDS)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:SICILIANO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 EAST GRASSY SPRAIN RD
Mailing Address - Street 2:103
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710
Mailing Address - Country:US
Mailing Address - Phone:914-337-5252
Mailing Address - Fax:914-337-1909
Practice Address - Street 1:35 EAST GRASSY SPRAIN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710
Practice Address - Country:US
Practice Address - Phone:914-337-5252
Practice Address - Fax:914-337-1909
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0490911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice