Provider Demographics
NPI:1649275074
Name:SCIARRA, JOSEPH PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:SCIARRA
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 1:22554 VENTURA BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1433
Mailing Address - Country:US
Mailing Address - Phone:818-224-2970
Mailing Address - Fax:818-224-2980
Practice Address - Street 1:22554 VENTURA BLVD
Practice Address - Street 2:STE 102
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1433
Practice Address - Country:US
Practice Address - Phone:818-224-2970
Practice Address - Fax:818-224-2980
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
CA278351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry