Provider Demographics
NPI:1134148018
Name:CIAMPA, JOSEPH HAROLD (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HAROLD
Last Name:CIAMPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 SHIRLEY ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1326
Mailing Address - Country:US
Mailing Address - Phone:617-846-5934
Mailing Address - Fax:617-846-3764
Practice Address - Street 1:562 SHIRLEY ST
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1326
Practice Address - Country:US
Practice Address - Phone:617-846-5934
Practice Address - Fax:617-846-3764
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA91441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice