Provider Demographics
NPI:1053141499
Name:GIRALDO MONCADA, KAREN ANDREA (DMD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANDREA
Last Name:GIRALDO MONCADA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 COLUMBUS AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-3903
Mailing Address - Country:US
Mailing Address - Phone:914-338-4989
Mailing Address - Fax:
Practice Address - Street 1:313 SE 15TH TER STE A
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4472
Practice Address - Country:US
Practice Address - Phone:954-427-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist