Provider Demographics
NPI:1962790634
Name:DUARTE, GILDA (DDS)
Entity type:Individual
Prefix:DR
First Name:GILDA
Middle Name:
Last Name:DUARTE
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 1:617 9TH AVE
Mailing Address - Street 2:APT 4N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3711
Mailing Address - Country:US
Mailing Address - Phone:917-326-1269
Mailing Address - Fax:
Practice Address - Street 1:339 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4729
Practice Address - Country:US
Practice Address - Phone:908-561-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024761001223X0400X
NY0556501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics