Provider Demographics
NPI:1093320806
Name:BURILO, ANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:BURILO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 W 10TH ST APT 207
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1293
Mailing Address - Country:US
Mailing Address - Phone:267-312-9340
Mailing Address - Fax:
Practice Address - Street 1:1727 STREETSBORO PLZ
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-5635
Practice Address - Country:US
Practice Address - Phone:330-626-3814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026311122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist