Provider Demographics
NPI:1922218023
Name:ODINGO, NORA A (DMD)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:A
Last Name:ODINGO
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:127 WESTCHESTER HL
Mailing Address - Street 2:STONY BROOK UNIVERSITY SCHOOL OF DENTAL MEDICINE
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8706
Mailing Address - Country:US
Mailing Address - Phone:631-632-8971
Mailing Address - Fax:
Practice Address - Street 1:110 SULLIVAN HL
Practice Address - Street 2:STONY BROOK DENTAL ASSOCIATES
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8705
Practice Address - Country:US
Practice Address - Phone:631-632-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY050811-11223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology