Provider Demographics
NPI:1396513537
Name:MEDEIROS SAAVEDRA DE PAULA, FLAVIA (DDS,PHD)
Entity type:Individual
Prefix:
First Name:FLAVIA
Middle Name:
Last Name:MEDEIROS SAAVEDRA DE PAULA
Suffix:
Gender:F
Credentials:DDS,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CONVENT DRIVE BUILDING 30 - 112
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:612-849-2157
Mailing Address - Fax:
Practice Address - Street 1:30 CONVENT DRIVE BUILDING 30 - 112
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:612-849-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ40531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist