Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mario Bradford Antonioni, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1255894762

Dr. Mario Bradford Antonioni, DDS is a Student in an Organized Health Care Education/Training Program in Venice, California. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

323 Lincoln Blvd
Venice, CA 90291-2842
Phone: (310) 392-4103
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1255894762
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 11, 2019
Last updated in NPPESApril 11, 2019

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