Provider Demographics
NPI:1184108169
Name:JOSEPH, MARIA (DDS)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 SANTA ANITA BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-4883
Mailing Address - Country:US
Mailing Address - Phone:214-534-1657
Mailing Address - Fax:
Practice Address - Street 1:1345 SANTA ANITA BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-4883
Practice Address - Country:US
Practice Address - Phone:214-534-1657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty