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General NPI Number Information
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NPI Number | 1720601529
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Entity Type | Individual
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Provider Name | KARLA ALICIA ORTIZ DDS, MPH
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 51 E 125TH ST
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City | NEW YORK
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State | NY
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Zip | 10035-1685
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Country | US
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Telephone | 877-573-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 125 BORINQUEN PL APT 313
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City | BROOKLYN
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State | NY
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Zip | 11211-4799
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 06203501
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License Number State | NY
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