Provider Demographics
NPI:1366004327
Name:SARMENTO, ANDREA MONTOYA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MONTOYA
Last Name:SARMENTO
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 1:3930 MCKINNEY AVE APT 542
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2084
Mailing Address - Country:US
Mailing Address - Phone:813-731-5671
Mailing Address - Fax:
Practice Address - Street 1:4949 HEDGCOXE RD STE 160
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3902
Practice Address - Country:US
Practice Address - Phone:813-731-5671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-30
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35348122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist