Provider Demographics
NPI:1437464518
Name:DUARTE, MONICA D (DDS)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:D
Last Name:DUARTE
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 1:2505 S BASCOM AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4302
Mailing Address - Country:US
Mailing Address - Phone:408-356-6106
Mailing Address - Fax:
Practice Address - Street 1:2074 FOREST AVE STE 3
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4811
Practice Address - Country:US
Practice Address - Phone:408-286-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA585881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice