Provider Demographics
NPI:1285093971
Name:D'ANDREA, REBECCA (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:D'ANDREA
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 1:44 OLD RIDGEFIELD RD STE 212
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3014
Mailing Address - Country:US
Mailing Address - Phone:203-761-0223
Mailing Address - Fax:203-955-1785
Practice Address - Street 1:44 OLD RIDGEFIELD RD STE 212
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3014
Practice Address - Country:US
Practice Address - Phone:203-761-0223
Practice Address - Fax:203-834-2249
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist