Provider Demographics
NPI:1184162174
Name:IORIO, AMANDA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:IORIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 DUBOIS AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3233
Mailing Address - Country:US
Mailing Address - Phone:516-408-8345
Mailing Address - Fax:
Practice Address - Street 1:21 SPRING VALLEY MARKET PL
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5210
Practice Address - Country:US
Practice Address - Phone:845-352-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0612171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program