Provider Demographics
NPI:1467912824
Name:OZIMBA-MBUYA, MIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIA
Middle Name:
Last Name:OZIMBA-MBUYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:MIA
Other - Middle Name:
Other - Last Name:OZIMBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:516 STRAND ST
Mailing Address - Street 2:
Mailing Address - City:FREDERIKSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00840-3533
Mailing Address - Country:US
Mailing Address - Phone:340-772-0260
Mailing Address - Fax:
Practice Address - Street 1:516 STRAND ST
Practice Address - Street 2:
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-3533
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program