Provider Demographics
NPI:1659991420
Name:D'ELIA, BRIANNA LYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:LYN
Last Name:D'ELIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COLUMBIA TPKE STE 102A
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2240
Mailing Address - Country:US
Mailing Address - Phone:973-301-0011
Mailing Address - Fax:
Practice Address - Street 1:29 COLUMBIA TPKE STE 102A
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2240
Practice Address - Country:US
Practice Address - Phone:973-301-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI027973001223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program