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General NPI Number Information
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NPI Number | 1366054223
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Entity Type | Individual
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Provider Name | IRIA A ONDO BENGONE DDS
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Gender | Female
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 7903 ORION CIR # C328
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City | LAUREL
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State | MD
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Zip | 20724-3101
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Country | US
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Telephone | 832-213-6429
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Fax |
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Provider Business Mailing Address
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Address Line | 7903 ORION CIR # C328
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City | LAUREL
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State | MD
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Zip | 20724-3101
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Country | US
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Telephone | 832-213-6429
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17729
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License Number State | MD
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