Provider Demographics
NPI:1013748169
Name:JIMENEZ PAZ, MARGYDALI (DDS)
Entity type:Individual
Prefix:
First Name:MARGYDALI
Middle Name:
Last Name:JIMENEZ PAZ
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 1:4422 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2106
Mailing Address - Country:US
Mailing Address - Phone:305-213-7350
Mailing Address - Fax:
Practice Address - Street 1:3625 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6164
Practice Address - Country:US
Practice Address - Phone:504-485-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA76021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice