Basic Information
| Provider Information | |||||||||
| NPI: | 1851901094 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OCHOA | ||||||||
| FirstName: | JAVIER | ||||||||
| MiddleName: | ANDRES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8321 SANDS POINT BLVD | ||||||||
| Address2: | APT 207 | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546483216 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18312 PINES BLVD | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330291412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862040713 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2020 | ||||||||
| LastUpdateDate: | 08/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DN25346 | FL | Y | Dental Providers | Dentist | General Practice |
No ID Information.