Provider Demographics
NPI:1275976771
Name:ALDAMA, EVELYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:ALDAMA
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 1:645 NE 127 ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161
Mailing Address - Country:US
Mailing Address - Phone:786-542-0421
Mailing Address - Fax:305-677-3449
Practice Address - Street 1:645 NE 127 ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161
Practice Address - Country:US
Practice Address - Phone:786-542-0421
Practice Address - Fax:305-677-3449
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN170451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice