Provider Demographics
NPI:1710267398
Name:VIEIRA, ERIN NICOLE-DEAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:NICOLE-DEAL
Last Name:VIEIRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:DEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:347 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-1385
Mailing Address - Country:US
Mailing Address - Phone:419-345-3253
Mailing Address - Fax:
Practice Address - Street 1:3927 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:CENTERBURG
Practice Address - State:OH
Practice Address - Zip Code:43011
Practice Address - Country:US
Practice Address - Phone:419-345-3253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30.023644OtherDENTAL BOARD