Provider Demographics
NPI:1447431523
Name:ORTIZ, PAULA ANDREA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:ANDREA
Last Name:ORTIZ
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 1:217 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7901
Mailing Address - Country:US
Mailing Address - Phone:214-864-7218
Mailing Address - Fax:
Practice Address - Street 1:8533 DAVIS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8311
Practice Address - Country:US
Practice Address - Phone:817-345-0659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-17
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300226651223P0300X
TX234731223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics