Provider Demographics
NPI:1801009428
Name:CARDONA, DOLOROSA BARTIDO (DMD)
Entity Type:Individual
Prefix:DR
First Name:DOLOROSA
Middle Name:BARTIDO
Last Name:CARDONA
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 1:5409 CENTRAL AVE
Mailing Address - Street 2:SUITE#17
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-4484
Mailing Address - Country:US
Mailing Address - Phone:510-796-4562
Mailing Address - Fax:510-796-4853
Practice Address - Street 1:5409 CENTRAL AVE
Practice Address - Street 2:SUITE#17
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-4484
Practice Address - Country:US
Practice Address - Phone:510-796-4562
Practice Address - Fax:510-796-4853
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice