Provider Demographics
NPI:1427018332
Name:DONGO, CARLOS ALBERTO (DDS)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:DONGO
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 1:861 HAROLD PL STE 303
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4555
Mailing Address - Country:US
Mailing Address - Phone:619-216-0166
Mailing Address - Fax:619-216-1672
Practice Address - Street 1:861 HAROLD PL STE 303
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4555
Practice Address - Country:US
Practice Address - Phone:619-216-0166
Practice Address - Fax:619-216-1672
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice