Provider Demographics
NPI:1134343346
Name:WEISS, HILDE (DDS)
Entity type:Individual
Prefix:MS
First Name:HILDE
Middle Name:
Last Name:WEISS
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 1:4731 NE 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-2110
Mailing Address - Country:US
Mailing Address - Phone:352-861-7084
Mailing Address - Fax:352-237-3196
Practice Address - Street 1:4731 NE 11TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-2110
Practice Address - Country:US
Practice Address - Phone:352-861-7084
Practice Address - Fax:352-237-3196
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN125711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL074511100Medicaid