DR. BRIAN L MATTIACIO (NPI# 1922129261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922129261 |
Entity Type | Individual |
Full Name | DR. BRIAN L MATTIACIO |
Credential | D.D.S., M.S. |
Practice Address |
1386 Hathaway Dr Farmington NY 14425-8973 |
Practice Telephone | 5857421050 |
Practice Fax Number | 5857421011 |
Mailing Telephone | 5857421050 |
Mailing Fax Number | 5857421011 |
Enumeration Date | 2007-04-03 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
051528 | NY | Dental Providers |
Street Address |
1386 HATHAWAY DR |
City | FARMINGTON |
State | NY |
Zip Code | 14425-8973 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285609131 | Michael Susco | Psychiatry & Neurology | 1386 Hathaway Dr, Suite A, Farmington, NY 14425-8973 | 2006-02-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982211827 | Laura Elizabeth Kilburg | Dietitian, Registered | 6371 Cedar Creek Way, Farmington, NY 14425 | 2020-09-24 |
1306215769 | Jenna Ratka | Specialist/Technologist | 5889 King Hill Dr, Farmington, NY 14425 | 2015-09-16 |
1922345255 | Alissa L Waughtel | Speech-Language Pathologist | 1578 Hayride Dr, Farmington, NY 14425 | 2013-01-07 |
1891964870 | Heather Patricia Munger | Licensed Practical Nurse | 5773 Limestone Lane, Farmington, NY 14425 | 2008-02-25 |
1306904834 | Richard R Bush | Dentist | 1484 State Route 332, Farmington, NY 14425 | 2006-12-05 |
1811072770 | Leonard Patrick Muscarella | Dentist | 1484 Rochester Rd. Rt. 332, Farmington, NY 14425 | 2006-10-26 |
1922111707 | John Michael Manfred | Internal Medicine | 1160 Corporate Dr, Farmington, NY 14425 | 2006-08-16 |
1811970445 | Edward H Davis | Optometrist | 6081 Rte 96 S, Farmington, NY 14425 | 2005-11-29 |
1114900651 | Eastview Vision Inc | Technician/Technologist | 6081 Route 96 S, Ste 8, Farmington, NY 14425 | 2005-11-29 |
1629131248 | Millers Pharmacy of Farmington | Pharmacy | 6181 Route 96, Farmington, NY 14425-1004 | 2006-12-18 |
Find all providers in zip 14425 |
Taxonomy Code | 1223X0400X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Orthodontics and Dentofacial Orthopedics |
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760024723 | Baliram Maraj | Dentist | 801 Plainville Ave., Farmington, CT 06032 | 2019-10-11 |
1871902593 | Sundance Orthodontics LLC | Dentist | 3903 Beckland Dr, Farmington, NM 87402-4701 | 2014-08-06 |
1417246562 | Dr. Joseph A. Wilson Dmd, Msd, LLC | Dentist | 4760 N Butler Ave Ste A, Farmington, NM 87401-0816 | 2011-03-29 |
1144460486 | Ernest Lee Stromeyer | Dentist | 2200 E 20th St, Farmington, NM 87401-8904 | 2009-02-26 |
1972748747 | Derek Jay Graff | Dentist | 3180 N Butler Ave Ste 200, Farmington, NM 87401-2336 | 2008-12-09 |
1780892414 | Justin Tyler Brown | Dentist | 670 Shepard Ln Ste 105, Farmington, UT 84025-3936 | 2007-05-18 |
1609990449 | Orthodontic Care Group | Dentist | 310 Division St, Farmington, MN 55024-1233 | 2007-03-19 |
1194853044 | C. Michael Beck | Dentist | 5605 La Veta Dr, Farmington, NM 87402-4911 | 2007-03-01 |
1710029632 | Rodney Kent Rhodes | Dentist | 130 Westmount Drive, Farmington, MO 63640 | 2007-02-14 |
1790822476 | David Michael Verlinich | Dentist | 303 Canyonview Dr, Farmington, NM 87401-8629 | 2007-01-31 |
Find all providers in FARMINGTON |
City | FARMINGTON |
Zip Code | 14425 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.