Provider Demographics
NPI:1194469924
Name:ESPERANZA, KRISTEN PAULA BURGOS (DDS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:PAULA BURGOS
Last Name:ESPERANZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SAMOSET ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4801
Mailing Address - Country:US
Mailing Address - Phone:508-746-5800
Mailing Address - Fax:
Practice Address - Street 1:125 SAMOSET ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4801
Practice Address - Country:US
Practice Address - Phone:508-746-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18597271223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223G0001XDental ProvidersDentistGeneral Practice