Provider Demographics
NPI:1831246446
Name:DORFMAN, GINA (DDS)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:DORFMAN
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 1:537 NEW LOS ANGELES AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2066
Mailing Address - Country:US
Mailing Address - Phone:805-529-1000
Mailing Address - Fax:805-507-9050
Practice Address - Street 1:537 NEW LOS ANGELES AVE STE E
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2066
Practice Address - Country:US
Practice Address - Phone:805-529-1000
Practice Address - Fax:805-507-9050
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA474681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice