Provider Demographics
NPI:1003153305
Name:CABRERA, VIANCA (DMD)
Entity type:Individual
Prefix:DR
First Name:VIANCA
Middle Name:
Last Name:CABRERA
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 1:2214 GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4706
Mailing Address - Country:US
Mailing Address - Phone:305-790-5857
Mailing Address - Fax:
Practice Address - Street 1:2645 SW 37TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2754
Practice Address - Country:US
Practice Address - Phone:786-808-2296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL117931223P0300X
FLDN196841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics