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NPI Code Detail

MEDICARE: MS. CARLA CECILIA CORNEJO RDH

MEDICARE: MS. CARLA CECILIA CORNEJO RDH
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
1124Q00000XDental Hygienist6860MD

General Provider Information

NPI Number : 1043172661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CARLA CECILIA CORNEJO RDH
Provider Business Mailing Address
First Line : 2333 ONTARIO RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2627
Country : US
Telephone Number : 202-545-8023
Fax Number :
Provider Business Practice Location Address
First Line : 2333 ONTARIO RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2627
Country : US
Telephone Number : 202-545-8023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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