Provider Demographics
NPI:1942491360
Name:NAVEDO, MARLENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:
Last Name:NAVEDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TOURAINE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4420
Mailing Address - Country:US
Mailing Address - Phone:347-393-4031
Mailing Address - Fax:
Practice Address - Street 1:100 TOURAINE AVE
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4420
Practice Address - Country:US
Practice Address - Phone:347-393-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0460941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice