Healthcare Provider Details

I. General information

NPI: 1568767440
Provider Name (Legal Business Name): VENEUSKA MARGARITA OCANDO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 12/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 E 9TH ST SUITE 1K
NEW YORK NY
10003-6311
US

IV. Provider business mailing address

55 E 9TH ST SUITE 1K
NEW YORK NY
10003-6311
US

V. Phone/Fax

Practice location:
  • Phone: 212-388-1170
  • Fax: 212-388-1181
Mailing address:
  • Phone: 212-388-1170
  • Fax: 212-388-1181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number10363
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number057699
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number11311
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: