Provider Demographics
NPI:1336891639
Name:SOMARRIBA, YANAIRDE (DDS)
Entity Type:Individual
Prefix:DR
First Name:YANAIRDE
Middle Name:
Last Name:SOMARRIBA
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 1:2522 LAKE DEBRA DR APT 21102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8737
Mailing Address - Country:US
Mailing Address - Phone:505-974-3670
Mailing Address - Fax:
Practice Address - Street 1:1100 N ALAFAYA TRL STE 160
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-5966
Practice Address - Country:US
Practice Address - Phone:407-277-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist