Provider Demographics
NPI:1558988238
Name:GARCIA GONZALEZ, JHEINY (DMD)
Entity Type:Individual
Prefix:
First Name:JHEINY
Middle Name:
Last Name:GARCIA GONZALEZ
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 1:16280 NW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6049
Mailing Address - Country:US
Mailing Address - Phone:786-424-8374
Mailing Address - Fax:
Practice Address - Street 1:16280 NW 45TH AVE
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-6049
Practice Address - Country:US
Practice Address - Phone:786-424-8374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist