Provider Demographics
NPI:1730486630
Name:PIERSE, JOSEPH EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:PIERSE
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 1:2060 W WHISPERING WIND DR STE 167
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-2869
Mailing Address - Country:US
Mailing Address - Phone:623-518-2325
Mailing Address - Fax:623-547-6002
Practice Address - Street 1:2060 W WHISPERING WIND DR STE 167
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-2869
Practice Address - Country:US
Practice Address - Phone:623-518-2325
Practice Address - Fax:623-547-6002
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-12
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0095621223P0700X, 1223S0112X
MADN100001251223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA355733Medicare PIN