Provider Demographics
NPI:1568182939
Name:PARRAGUIRRE, YESENIA ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:YESENIA
Middle Name:ELIZABETH
Last Name:PARRAGUIRRE
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 1:3510 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1428
Mailing Address - Country:US
Mailing Address - Phone:410-330-2355
Mailing Address - Fax:
Practice Address - Street 1:1664 VILLAGE GRN
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2037
Practice Address - Country:US
Practice Address - Phone:301-215-2653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD176321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice