Provider Demographics
NPI:1730602780
Name:ALDAMA, GIOVANNI ALEXANDER (DMD)
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:ALEXANDER
Last Name:ALDAMA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2253 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4901
Mailing Address - Country:US
Mailing Address - Phone:786-301-2474
Mailing Address - Fax:
Practice Address - Street 1:348 ALHAMBRA CIR STE A
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5004
Practice Address - Country:US
Practice Address - Phone:305-317-9887
Practice Address - Fax:305-513-5175
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10575122300000X
FL22599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist