Provider Demographics
NPI:1609919240
Name:CONDE, NIMFA (DDS)
Entity Type:Individual
Prefix:MS
First Name:NIMFA
Middle Name:
Last Name:CONDE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:NIMFA
Other - Middle Name:
Other - Last Name:CONDE-NADORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:P.O. BOX 11867
Mailing Address - Street 2:CORRECTIONAL HEALTH, 2ND FLOOR
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93775-1867
Mailing Address - Country:US
Mailing Address - Phone:559-600-3229
Mailing Address - Fax:559-445-2772
Practice Address - Street 1:1225 M STREET
Practice Address - Street 2:CORRECTIONAL HEALTH, 2ND FLOOR
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1805
Practice Address - Country:US
Practice Address - Phone:559-442-2404
Practice Address - Fax:559-442-5277
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist