Provider Demographics
NPI:1013754092
Name:DUTA-LLANGARI, CYNTHIA JHAMILEX (DDS)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JHAMILEX
Last Name:DUTA-LLANGARI
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 1:3205 19TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-2401
Mailing Address - Country:US
Mailing Address - Phone:615-927-9764
Mailing Address - Fax:
Practice Address - Street 1:6520 150TH ST W STE 300
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-6584
Practice Address - Country:US
Practice Address - Phone:952-241-5888
Practice Address - Fax:952-241-5887
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND15144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist