Provider Demographics
NPI:1427018332
Name:DONGO, CARLOS ALBERTO (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:DONGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 A AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2228
Mailing Address - Country:US
Mailing Address - Phone:619-336-1900
Mailing Address - Fax:619-336-1984
Practice Address - Street 1:705 A AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2228
Practice Address - Country:US
Practice Address - Phone:619-336-1900
Practice Address - Fax:619-336-1984
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice