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General NPI Number Information
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NPI Number | 1881836963
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Entity Type | Individual
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Provider Name | INES ALEJANDRA ORTA D.D.S
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Gender | Female
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 6600 WEST 12TH AVENUE.
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City | HIALEAH
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State | FL
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Zip | 33012
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Country | US
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Telephone | 305-788-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 1723 SW 2ND AVE UNIT 802.
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City | MIAMI
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State | FL
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Zip | 33129
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Country | US
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Telephone | 305-788-2613
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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 | 55321
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License Number State | CA
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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 | 20345
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License Number State | FL
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