Individual provider Active NPI

Louis J. Cianciola, DDS,MS

  • Periodontics
  • Rochester, NY
National Provider Identifier
1861553778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
030525 Issued in NY
Practice address
2005 Lyell Ave
Rochester, NY 14606-2323
Phone
(585) 458-5456
Fax
(585) 458-9782
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 030525 NY Primary

Addresses

Primary practice location

2005 Lyell Ave
Rochester, NY 14606-2323

Mailing address

2005 Lyell Ave
Rochester, NY 14606-2323
Phone (585) 458-5456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861553778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 LYELL AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062323",
            "telephone_number": "585-458-5456",
            "fax_number": "585-458-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 LYELL AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062323",
            "telephone_number": "585-458-5456",
            "fax_number": "585-458-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIANCIOLA",
        "first_name": "LOUIS",
        "middle_name": "J.",
        "credential": "DDS,MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "030525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.