Provider Demographics
NPI:1750906244
Name:PACHECO, ORIANA M (DMD)
Entity type:Individual
Prefix:
First Name:ORIANA
Middle Name:M
Last Name:PACHECO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 NE 2ND ST APT 2406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-2295
Mailing Address - Country:US
Mailing Address - Phone:954-604-1379
Mailing Address - Fax:
Practice Address - Street 1:9835 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3993
Practice Address - Country:US
Practice Address - Phone:786-578-0756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN249331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice