Provider Demographics
NPI:1841481371
Name:GINDE, MAYURA K (DDS)
Entity type:Individual
Prefix:
First Name:MAYURA
Middle Name:K
Last Name:GINDE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MAYURA
Other - Middle Name:
Other - Last Name:RAMESH PRADHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:926 GREAT POND DR
Mailing Address - Street 2:SUITE 2003
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7244
Mailing Address - Country:US
Mailing Address - Phone:407-772-5124
Mailing Address - Fax:407-788-3572
Practice Address - Street 1:1724 MOUNT ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-2115
Practice Address - Country:US
Practice Address - Phone:412-213-1999
Practice Address - Fax:412-213-6985
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037133122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist