Provider Demographics
NPI:1083825665
Name:ESPINOSA, RICARDO J (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:J
Last Name:ESPINOSA
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 1:8128 NW 103RD ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2204
Mailing Address - Country:US
Mailing Address - Phone:305-558-8626
Mailing Address - Fax:305-827-6647
Practice Address - Street 1:8128 NW 103RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2204
Practice Address - Country:US
Practice Address - Phone:305-558-8626
Practice Address - Fax:305-827-6647
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist