Provider Demographics
NPI:1518541135
Name:RODRIGUEZ MONAGAS, MARYLIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARYLIN
Middle Name:
Last Name:RODRIGUEZ MONAGAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3258
Mailing Address - Country:US
Mailing Address - Phone:609-233-1783
Mailing Address - Fax:
Practice Address - Street 1:3003 ENGLISH CREEK AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-4863
Practice Address - Country:US
Practice Address - Phone:609-484-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI02888300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program