DENTAL SPECIALISTS OF PEMBROKE PINES GROUP (NPI# 1073030755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073030755 |
| Entity Type | Organization |
| Organization Name | DENTAL SPECIALISTS OF PEMBROKE PINES GROUP |
| Practice Address |
12558 Pines Blvd Pembroke Pines FL 33027-1713 |
| Practice Telephone | 3052208911 |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |
| Authorized Official Name | DR. IVAN PELTON (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 3052208911 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN5838 | FL | Dental Providers |
| Street Address |
12558 PINES BLVD |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33027-1713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235243189 | Ivan Pelton | Dentist | 12558 Pines Blvd, Pembroke Pines, FL 33027-1713 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474808 | A&d Community Mental Health, LLC | Community/Behavioral Health | 1333 Sw 16th Ave, Pembroke Pines, FL 33027 | 2020-10-12 |
| 1275172256 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 12681 Miramar Parkway, Miramar, FL 33027 | 2019-12-23 |
| 1902449424 | Marine M Brown | Nurse Practitioner | 4343 Sw 128th Avenue, Mirmar, FL 33027 | 2019-10-28 |
| 1427699107 | Suncare Therapy, Inc | Physical Therapist | 111 Grant Palms Dr, Pembroke Pines, FL 33027 | 2019-10-03 |
| 1245888080 | Nicole Angelique Munoz | Nurse Practitioner | 12600 Pembroke Rd Ste 200, Miramar, FL 33027 | 2019-08-26 |
| 1770052334 | Katalyst Health, LLC | Family Medicine | 14704 Sw 11 Street, Pembroke Pines, FL 33027 | 2018-11-13 |
| 1700362076 | Jovani Miguel Gonzalez | Dentist | 3600 Sw 163rd Ave, Miramar, FL 33027 | 2018-07-19 |
| 1336648310 | Janelle Monique Mitchell | Behavior Technician | 3350 Sw 148th Ave Suite 110, Miramar, FL 33027 | 2018-02-06 |
| 1437667557 | Elizabeth Connors | Specialist/Technologist | 17089 Sw 16th St, Pembroke Pines, FL 33027 | 2018-01-11 |
| 1992217806 | Bibi Farida Roberts | Counselor | 3590 Sw 142nd Ave, Miramar, FL 33027 | 2017-11-01 |
| Find all providers in zip 33027 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477161594 | Shantall Di Loreto Parra | Dentist | 600 N Hiatus Rd Ste 103, Pembroke Pines, FL 33026-5207 | 2020-07-14 |
| 1831725282 | Annabel Perez Pllc | Dentist | 18450 Pines Blvd Ste 202, Pembroke Pines, FL 33029-1423 | 2020-03-18 |
| 1881243855 | Friedland Family Dentistry | Dentist | 10031 Pines Blvd # W101, Pembroke Pines, FL 33024-6179 | 2019-09-11 |
| 1699337253 | Eduardo Enrique Garcia Perez | Dentist | 17868 Nw 2nd St, Pembroke Pines, FL 33029-2806 | 2019-07-03 |
| 1891235321 | Hugo Daniel Pozaicer Uribe | Dentist | 18503 Pines Blvd Ste 208, Pembroke Pines, FL 33029 | 2017-03-02 |
| 1356892467 | Total Dental Centers, Pllc | Dentist | 12169 Pembroke Rd, Pembroke Pines, FL 33025-1727 | 2016-10-24 |
| 1316353360 | Dental Choice Mobile Florida LLC | Dentist | 11077 Sw 5th Ct, Pembroke Pines, FL 33025-7025 | 2014-07-09 |
| 1447694799 | Lazcano Family Dental P.a | Dentist | 10051 Pines Blvd Ste C, Pembroke Pines, FL 33024-6172 | 2013-04-17 |
| 1720329766 | Christina Sofia Hernandez | Dentist | 1520 Sw 194th Ter, Pembroke Pines, FL 33029-6160 | 2013-03-14 |
| 1063757912 | Lakes Mall Dental Center, Pa | Dentist | 11401 Pines Blvd Ste 220, Pembroke Pines, FL 33026-4104 | 2012-12-04 |
| Find all providers in PEMBROKE PINES | ||||
| City | PEMBROKE PINES |
| Zip Code | 33027 |
Please comment or provide details below to improve the information on DENTAL SPECIALISTS OF PEMBROKE PINES GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.