Provider Demographics
NPI:1316691397
Name:VILELA, DANUZA
Entity type:Individual
Prefix:
First Name:DANUZA
Middle Name:
Last Name:VILELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 STEWART AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6611
Mailing Address - Country:US
Mailing Address - Phone:516-396-0187
Mailing Address - Fax:
Practice Address - Street 1:101 S BERGEN PL
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3528
Practice Address - Country:US
Practice Address - Phone:516-623-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist