Provider Demographics
NPI:1932283413
Name:SCIPIONE, RICHARD E (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:SCIPIONE
Suffix:
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 1:121 TWINS LANE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460
Mailing Address - Country:US
Mailing Address - Phone:985-781-6096
Mailing Address - Fax:
Practice Address - Street 1:600 N HWY 190
Practice Address - Street 2:SUITE 4
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-893-5522
Practice Address - Fax:985-871-0742
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice