Provider Demographics
NPI:1508653429
Name:REGO, OLIVIA MADALENA DASILVA (RDH)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MADALENA DASILVA
Last Name:REGO
Suffix:
Gender:
Credentials:RDH
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:MADALENA
Other - Last Name:DASILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:10 POND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1512
Mailing Address - Country:US
Mailing Address - Phone:203-768-4509
Mailing Address - Fax:
Practice Address - Street 1:10 POND VIEW DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1512
Practice Address - Country:US
Practice Address - Phone:203-768-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9103124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist