Provider Demographics
NPI:1023171667
Name:JOSEPH, DANIEL IRWIN (DDS,MS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:IRWIN
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5704
Mailing Address - Country:US
Mailing Address - Phone:304-242-7222
Mailing Address - Fax:304-242-1389
Practice Address - Street 1:1136 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5704
Practice Address - Country:US
Practice Address - Phone:304-242-7222
Practice Address - Fax:304-242-1389
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics