Provider Demographics
NPI:1689353856
Name:CABALLERO OCHOA, KIZZY (DMD)
Entity Type:Individual
Prefix:
First Name:KIZZY
Middle Name:
Last Name:CABALLERO OCHOA
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 1:16452 SW 58TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5682
Mailing Address - Country:US
Mailing Address - Phone:786-230-9650
Mailing Address - Fax:
Practice Address - Street 1:6641 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7919
Practice Address - Country:US
Practice Address - Phone:786-230-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL283081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice