Provider Demographics
NPI:1922657840
Name:PARADA, ESTEBAN (DMD)
Entity Type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:
Last Name:PARADA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:ESTEBAN
Other - Middle Name:
Other - Last Name:PARADA ORTEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:13851 SW 38TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6490
Mailing Address - Country:US
Mailing Address - Phone:786-797-0443
Mailing Address - Fax:
Practice Address - Street 1:13550 SW 88TH ST STE 112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1539
Practice Address - Country:US
Practice Address - Phone:786-797-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist