Provider Demographics
NPI:1578732822
Name:BIRD, OLGA (DDS)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:BIRD
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 1:2642 E ORCHARD CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6781
Mailing Address - Country:US
Mailing Address - Phone:954-476-2524
Mailing Address - Fax:
Practice Address - Street 1:6491 SUNSET STRIP
Practice Address - Street 2:SUITE 1
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-2867
Practice Address - Country:US
Practice Address - Phone:954-572-1801
Practice Address - Fax:954-572-4195
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
18007521547OtherDENTAMAX
18776383379OtherMETLIFE
18002446224OtherCIGNA
9546387948OtherNATURALISTIC
18002446224OtherHEALTH ASE
18003425209OtherCOMPBENEFITS
1632454OtherUNITED CONCORDIA
18002563368OtherAMERIPLAN
18883358227OtherDELTA DENTAL
8004517715OtherAETNA
9544379781OtherNAVEDENT
18004410380OtherCARRINGTON
18666332446OtherUNITED HEALTH CARE
8005584444OtherHUMANAR CARRINGTONG
18006354238OtherSAFEGUARD
18008473995OtherSUMMITT
18009647811OtherADI
18009647911OtherGUARDIAN