Provider Demographics
NPI:1518339217
Name:BUHAY-OGILVIE, MONICA CHRISEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:CHRISEL
Last Name:BUHAY-OGILVIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:CHRISEL
Other - Last Name:BUHAY-OGILVIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:15 N NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1708
Mailing Address - Country:US
Mailing Address - Phone:719-576-1850
Mailing Address - Fax:719-576-1929
Practice Address - Street 1:6725 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-1904
Practice Address - Country:US
Practice Address - Phone:301-773-4746
Practice Address - Fax:301-773-4941
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001565122300000X
MD161491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC074053700Medicaid
MD04865230Medicaid