Provider Demographics
NPI:1912090911
Name:FINELLI, JOSEPH FREDERICK JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FREDERICK
Last Name:FINELLI
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 1:5109 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-2352
Mailing Address - Country:US
Mailing Address - Phone:315-487-2668
Mailing Address - Fax:315-487-8661
Practice Address - Street 1:5109 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2352
Practice Address - Country:US
Practice Address - Phone:315-487-2668
Practice Address - Fax:315-487-8661
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03823811223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01627527Medicaid
B81134Medicare UPIN
NY01627527Medicaid