Provider Demographics
NPI:1154702777
Name:GIRALDO, DORIS (DDS)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:GIRALDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 58TH ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1236
Mailing Address - Country:US
Mailing Address - Phone:212-750-4590
Mailing Address - Fax:212-751-1752
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:SUITE 506
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:212-750-4590
Practice Address - Fax:212-751-1752
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0428511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice