Provider Demographics
NPI:1497348361
Name:DE OLIVEIRA SILVA, TANIA L (DDS)
Entity Type:Individual
Prefix:
First Name:TANIA L
Middle Name:
Last Name:DE OLIVEIRA SILVA
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 1:7468 LEIGHSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5717
Mailing Address - Country:US
Mailing Address - Phone:407-371-9279
Mailing Address - Fax:
Practice Address - Street 1:9275 SW 152ND ST STE 106
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1773
Practice Address - Country:US
Practice Address - Phone:305-233-6575
Practice Address - Fax:786-802-1844
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN28368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist