Provider Demographics
NPI:1780439067
Name:LOPEZ-CENTELLAS, DAYNA (RDH, OMT)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:
Last Name:LOPEZ-CENTELLAS
Suffix:
Gender:F
Credentials:RDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 BECKLEY LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-9057
Mailing Address - Country:US
Mailing Address - Phone:206-619-3839
Mailing Address - Fax:
Practice Address - Street 1:828 BECKLEY LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-9057
Practice Address - Country:US
Practice Address - Phone:206-619-3839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402208673124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist