Provider Demographics
NPI:1225245236
Name:RONDON-TRINIDAD, BETTY MARGARITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:MARGARITA
Last Name:RONDON-TRINIDAD
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 1:2570 ROUTE 9W STE 10
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1370
Mailing Address - Country:US
Mailing Address - Phone:845-220-3100
Mailing Address - Fax:
Practice Address - Street 1:27 NORTH ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5012
Practice Address - Country:US
Practice Address - Phone:845-342-3900
Practice Address - Fax:845-342-1813
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0414261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01218175Medicaid