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General NPI Number Information
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NPI Number | 1962571224
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Entity Type | Individual
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Provider Name | CONDRA G GAINES-ONIWINDE DDS
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1146 STUYVESANT AVENUE
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City | IRVINGTON
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State | NJ
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Zip | 07111
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Country | US
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Telephone | 973-399-4242
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Fax | 973-399-4440
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Provider Business Mailing Address
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Address Line | 10 WOODBRIDGE CENTER DR
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1152
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Country | US
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Telephone | 732-914-3991
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Fax | 908-387-8322
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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 | DI2115400
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License Number State | NJ
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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 | DI021154
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License Number State | NJ
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