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NPI Code Detail

MEDICARE: DESIRE RENGGLI

MEDICARE:   DESIRE  RENGGLI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry17650MD

General Provider Information

NPI Number : 1013597129
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIRE RENGGLI
Provider Business Mailing Address
First Line : 2120 TROON OVERLOOK APT 101
Second Line :
City : WOODSTOCK
State : MD
Zip : 21163-1452
Country : US
Telephone Number : 443-285-3591
Fax Number :
Provider Business Practice Location Address
First Line : 5126 DORSEY HALL DR
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-7887
Country : US
Telephone Number : 410-740-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2021
Last Update Date : 10/20/2025

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Directions to “ DESIRE RENGGLI ” Practice Location

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