Provider Demographics
NPI:1598654204
Name:URAYENEZA, ESPERANCE (DDS)
Entity type:Individual
Prefix:
First Name:ESPERANCE
Middle Name:
Last Name:URAYENEZA
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 1:1915 E 110TH PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-0183
Mailing Address - Country:US
Mailing Address - Phone:312-568-6562
Mailing Address - Fax:
Practice Address - Street 1:3506 VILLAGE CT
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-1428
Practice Address - Country:US
Practice Address - Phone:219-985-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014823A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice