# JOSEPH CERAVOLO DDS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457521361
- **Authorized official:** JOSEPH CERAVOLO DDS (CEO)
- **Authorized official phone:** (310) 990-1636

## Contact information

- **Practice address:** 1304 15TH ST, STE 314, SANTA MONICA, CA 90404-1809
- **Practice address phone:** (310) 394-5879
- **Mailing address:** 322 CULVER BLVD, STE \#274, PLAYA DEL REY, CA 90293-7704
- **Mailing address phone:** (310) 990-1636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 48513 | CA | Yes |

## Other

- **Enumeration date:** 03/06/2008
- **Last updated:** 03/06/2008