Provider Demographics
NPI:1083302673
Name:VIGNOGNA, REBECCA MARY (DMD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARY
Last Name:VIGNOGNA
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 1:1177 MAMARONECK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-4806
Mailing Address - Country:US
Mailing Address - Phone:315-558-9187
Mailing Address - Fax:
Practice Address - Street 1:1478 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5938
Practice Address - Country:US
Practice Address - Phone:203-255-6851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT145101223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry