Provider Demographics
NPI:1598651002
Name:OSENDI TRAVIESO, DEBORAH (DMD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:OSENDI TRAVIESO
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 1:1120 S WILLIAMS ST APT C9
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2932
Mailing Address - Country:US
Mailing Address - Phone:561-797-1638
Mailing Address - Fax:
Practice Address - Street 1:1120 S WILLIAMS ST APT C9
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2932
Practice Address - Country:US
Practice Address - Phone:561-797-1638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0361381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice