Provider Demographics
NPI:1417026196
Name:OGANDO, DORA MARIA (DDS)
Entity Type:Individual
Prefix:MS
First Name:DORA MARIA
Middle Name:
Last Name:OGANDO
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 1:107 WEST 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:914-699-7200
Mailing Address - Fax:914-699-0837
Practice Address - Street 1:599 W 190TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3566
Practice Address - Country:US
Practice Address - Phone:212-927-0090
Practice Address - Fax:212-927-8543
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048533-1122300000X
NY048533122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist