Provider Demographics
NPI:1952392219
Name:SPERANDIO, FILIPPO (DDS)
Entity Type:Individual
Prefix:DR
First Name:FILIPPO
Middle Name:
Last Name:SPERANDIO
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:HORIZON DENTAL CENTER
Mailing Address - Street 2:107-50 QUEEND BLVD
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-793-1777
Mailing Address - Fax:718-268-4886
Practice Address - Street 1:HORIZON DENTAL CENTER
Practice Address - Street 2:107-50 QUEEND BLVD
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-793-1777
Practice Address - Fax:718-268-4886
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0388071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00927573Medicaid