Dislaidy Garcia Ortega, DMD
Individual provider Active NPI General Practice Dentistry · Lodi, NJ
NPI 1972321032 · NPPES record last updated Sep 27, 2024
Key facts
- NPI
- 1972321032
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22D103054900 (NJ)
- Practice address
- 404 Farnham Ave
Lodi, NJ 07644-1205 - Phone
- (512) 294-1132
- NPI assigned
- Sep 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22D103054900 | NJ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22D103054900 | NJ | Yes |
Addresses
Primary practice location
404 Farnham Ave
Lodi, NJ 07644-1205
Mailing address
404 Farnham Ave
Lodi, NJ 07644-1205
Phone (512) 294-1132
Other providers in Lodi, NJ
- G O E M S LLC
- Mayank Gadhia
- Roel P Galope
- Emily Gamper
- Jal Gandhi
- Rose Ann Marie Garnett
- John A Gasataya
- Viktor Gashi
- Nabil Gerges
- Charlotte J Gibbs
All providers in Lodi, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.