Provider Demographics
NPI:1851419782
Name:PIAZZA, JOE M JR (DDS)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:M
Last Name:PIAZZA
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21212 NORTHWEST FWY
Mailing Address - Street 2:SUITE 275
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5884
Mailing Address - Country:US
Mailing Address - Phone:281-664-8100
Mailing Address - Fax:281-664-8104
Practice Address - Street 1:21212 NORTHWEST FWY
Practice Address - Street 2:SUITE 275
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5884
Practice Address - Country:US
Practice Address - Phone:281-664-8100
Practice Address - Fax:281-664-8104
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742113157OtherTAX ID
TX742113157OtherTAX ID