Provider Demographics
NPI:1598400038
Name:MATANGIRA, ROPAFADZO GRACE (DDS)
Entity type:Individual
Prefix:
First Name:ROPAFADZO
Middle Name:GRACE
Last Name:MATANGIRA
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 1:201 4TH ST S UNIT 806
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4587
Mailing Address - Country:US
Mailing Address - Phone:980-254-3717
Mailing Address - Fax:
Practice Address - Street 1:3338 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-1846
Practice Address - Country:US
Practice Address - Phone:727-359-0371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN289531223G0001X
CT13396390200000X
GADN1232351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program