Provider Demographics
NPI:1629594148
Name:JOHN E TIANO DDS PA
Entity Type:Organization
Organization Name:JOHN E TIANO DDS PA
Other - Org Name:MARSH COVE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-600-7309
Mailing Address - Street 1:6654 COLLIER BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-8178
Mailing Address - Country:US
Mailing Address - Phone:239-331-3575
Mailing Address - Fax:
Practice Address - Street 1:6654 COLLIER BLVD STE 104
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-8178
Practice Address - Country:US
Practice Address - Phone:412-600-7309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN224841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty