Provider Demographics
NPI:1164125712
Name:CARANDANG, REY GABRIEL BONJE (DDS)
Entity Type:Individual
Prefix:DR
First Name:REY GABRIEL
Middle Name:BONJE
Last Name:CARANDANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 TRAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-8764
Mailing Address - Country:US
Mailing Address - Phone:720-804-9440
Mailing Address - Fax:
Practice Address - Street 1:3216 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1043
Practice Address - Country:US
Practice Address - Phone:303-442-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODEN.002056001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program