Provider Demographics
NPI:1336319524
Name:VARGAS, ELLEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:DIRECT
Other - Middle Name:DENTAL
Other - Last Name:SOLUTIONS NORTH PLLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:105 VIA VERACRUZ
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6912
Mailing Address - Country:US
Mailing Address - Phone:561-308-5854
Mailing Address - Fax:
Practice Address - Street 1:105 VIA VERACRUZ
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6912
Practice Address - Country:US
Practice Address - Phone:561-308-5854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist