Provider Demographics
NPI:1386391159
Name:OGO DORADO, LLC
Entity type:Organization
Organization Name:OGO DORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUNILDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ORTIZ GIULIANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:787-927-3581
Mailing Address - Street 1:DORAMAR PLAZA 7016 CARR 693 STE 7
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-3488
Mailing Address - Country:US
Mailing Address - Phone:787-270-2737
Mailing Address - Fax:
Practice Address - Street 1:CARR. 659 KM 1.5 BO MAGUAYO
Practice Address - Street 2:DORAMAR PLAZA B2-65
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-3488
Practice Address - Country:US
Practice Address - Phone:787-270-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1073852851OtherNPI