Provider Demographics
NPI:1912741661
Name:VILLAR MONDRY, REBEKAH MARIE (DMD, MPH, MSW)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:MARIE
Last Name:VILLAR MONDRY
Suffix:
Gender:F
Credentials:DMD, MPH, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6096 SW 78TH CIR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-2013
Mailing Address - Country:US
Mailing Address - Phone:941-228-5128
Mailing Address - Fax:
Practice Address - Street 1:1325 NE 42ND ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34479-8635
Practice Address - Country:US
Practice Address - Phone:352-789-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist