Provider Demographics
NPI:1992791966
Name:DIRIENZO, STEVEN ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:DIRIENZO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3088
Mailing Address - Country:US
Mailing Address - Phone:201-858-1400
Mailing Address - Fax:
Practice Address - Street 1:925 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3088
Practice Address - Country:US
Practice Address - Phone:201-858-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0218701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery