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General NPI Number Information
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NPI Number | 1598118739
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Entity Type | Individual
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Provider Name | SANDRA OGANDO D.M.D
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Gender | Female
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 302 NW 179TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2818
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Country | US
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Telephone | 954-374-9215
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Fax | 954-589-0290
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Provider Business Mailing Address
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Address Line | 302 NW 179TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2818
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Country | US
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Telephone | 954-374-9215
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Fax | 954-589-0290
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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 | DN 22029
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN22029
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License Number State | FL
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