Healthcare Provider Details

I. General information

NPI: 1003515719
Provider Name (Legal Business Name): ANDREA HLINKA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 BROAD ST STE 101
PROVIDENCE RI
02907-1444
US

IV. Provider business mailing address

26 AVE AT PORT IMPERIAL APT 333
WEST NEW YORK NJ
07093-8395
US

V. Phone/Fax

Practice location:
  • Phone: 401-751-9050
  • Fax:
Mailing address:
  • Phone: 347-863-7224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03046100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: