Provider Demographics
NPI:1639457625
Name:CICCIO, JOSEPH ANTHONY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:CICCIO
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 PONDFIELD RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3706
Mailing Address - Country:US
Mailing Address - Phone:914-337-4700
Mailing Address - Fax:
Practice Address - Street 1:1 PONDFIELD RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3706
Practice Address - Country:US
Practice Address - Phone:914-337-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0376241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics