Provider Demographics
NPI:1659360766
Name:GIANADDA, ROBERT A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:GIANADDA
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 1:107 DELAWARE AVE
Mailing Address - Street 2:MEZZANINE LEVEL, STATLER TOWERS
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-2810
Mailing Address - Country:US
Mailing Address - Phone:716-854-5543
Mailing Address - Fax:716-854-5545
Practice Address - Street 1:125 LAWRENCE BELL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7817
Practice Address - Country:US
Practice Address - Phone:716-854-5543
Practice Address - Fax:716-854-5545
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0285281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00593646Medicaid