Provider Demographics
NPI:1568166411
Name:DIVILIO, VICTORIA (DDS)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DIVILIO
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 1:628 ELLICOTT ST APT 320
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1270
Mailing Address - Country:US
Mailing Address - Phone:631-275-1325
Mailing Address - Fax:
Practice Address - Street 1:1520 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14217-1212
Practice Address - Country:US
Practice Address - Phone:716-427-6453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064244122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist