Provider Demographics
NPI:1750948949
Name:MUNOZ, ANGEE TATIANA (DMD)
Entity type:Individual
Prefix:
First Name:ANGEE
Middle Name:TATIANA
Last Name:MUNOZ
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 1:575 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3953
Mailing Address - Country:US
Mailing Address - Phone:201-281-8407
Mailing Address - Fax:
Practice Address - Street 1:10 W WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-2290
Practice Address - Country:US
Practice Address - Phone:201-281-8407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028017001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice