Provider Demographics
NPI:1386812063
Name:ORTEGA, ARMANDO (DDS)
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4656 E MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-5234
Mailing Address - Country:US
Mailing Address - Phone:407-282-2313
Mailing Address - Fax:407-282-4948
Practice Address - Street 1:4656 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-5234
Practice Address - Country:US
Practice Address - Phone:407-282-2313
Practice Address - Fax:407-282-4948
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN152191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice