Provider Demographics
NPI:1043753577
Name:NEWMAN, BIANCA (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 WELHAM ST APT 348
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6849
Mailing Address - Country:US
Mailing Address - Phone:407-758-3524
Mailing Address - Fax:
Practice Address - Street 1:12711 NARCOOSSEE RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6991
Practice Address - Country:US
Practice Address - Phone:407-627-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN231041223P0300X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics