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General NPI Number Information
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NPI Number | 1417687070
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Entity Type | Individual
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Provider Name | BELEMA NGOZI OGBANGA-FARINAS DMD, MPH
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Gender | Female
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 13983 W WADDELL RD STE 104
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City | SURPRISE
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State | AZ
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Zip | 85379-8735
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Country | US
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Telephone | 623-232-3215
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 E PUGET AVE APT 5
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City | PHOENIX
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State | AZ
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Zip | 85020-6121
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Country | US
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Telephone | 623-698-4493
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D011389
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License Number State | AZ
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