CORAL DENTAL SPECIALISTS LLC (NPI# 1316402878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316402878 |
| Entity Type | Organization |
| Organization Name | CORAL DENTAL SPECIALISTS LLC |
| Practice Address |
11332 Wiles Rd Coral Springs FL 33076-2114 |
| Practice Telephone | 9546421013 |
| Mailing Telephone | 9546421013 |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |
| Authorized Official Name | PRATHIMA ADUSUMILLI (OWNER) |
| Authorized Official Telephone | 9546421013 |
| Authorized Official Credential | DMD, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
11332 WILES RD |
| City | CORAL SPRINGS |
| State | FL |
| Zip Code | 33076-2114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891096533 | Prathima Krishna Adusumilli | Dentist | 11332 Wiles Rd, Coral Springs, FL 33076-2114 | 2010-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518589134 | Zachary Scott Johnson | Dietitian, Registered | 10150 Nw 58th Ct, Parkland, FL 33076 | 2020-05-18 |
| 1730709692 | Zach Carl Rice | Counselor | 12155 Nw, 71st, Parkland, FL 33076 | 2020-04-21 |
| 1184268062 | Saul Grabosky | Pharmacist | 6001 Coral Ridge Drive, Coral Springs, FL 33076 | 2019-11-04 |
| 1295205359 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 4621 Coral Ridge Dr., Coral Springs, FL 33076 | 2018-12-03 |
| 1497263636 | Nathalie Toro | Behavioral Analyst | 7796 Nw 110th Dr., Parkland, FL 33076 | 2018-01-22 |
| 1124532668 | Melissa Danielle Winter | Developmental Therapist | 8191 Canopy Ter, Parkland, FL 33076 | 2017-11-20 |
| 1821510546 | Sheryl Santiago Delgado | Physical Therapist | 4789 Nw 116th Ter, Coral Springs, FL 33076 | 2017-07-14 |
| 1730600453 | Ieda Schumacher Faircloth | Surgery | 4811 Nw 103 Drive, Coral Springs, FL 33076 | 2017-07-03 |
| 1679015069 | Riley Nguyen | Physical Therapy Assistant | 5830 Coral Ridge Drive S-300, Coral Springs, FL 33076 | 2016-11-16 |
| 1508313578 | Paola Alejandra Kesman | Dentist | 11980 Nw 81 Court, Parkland, FL 33076 | 2016-09-07 |
| Find all providers in zip 33076 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902216153 | James Bennett Jr. | Dentist | 10188 Nw 31st St, Coral Springs, FL 33065-3913 | 2014-04-28 |
| 1932487725 | Aline Morin | Dentist | 7663 W Sample Rd, Coral Springs, FL 33065-4718 | 2011-07-27 |
| 1023304391 | Aurelio Antonio Bula | Dentist | 5850 Coral Ridge Dr Ste 101b, Coral Springs, FL 33076 | 2011-06-24 |
| 1235279050 | Frederic G Kirsch | Dentist | 1881 N University Dr Ste 201, Coral Springs, FL 33071-6095 | 2007-02-08 |
| 1073680161 | South Florida Dentistry for Children, P.a. | Dentist | 10188 Nw 31st Street, Coral Springs, FL 33065 | 2006-11-30 |
| 1235218686 | Maria Portilla | Dentist | 8150 Royal Palm Blvd Ste 104, Coral Springs, FL 33065-5704 | 2006-11-06 |
| 1790708865 | Enrique Acosta | Dentist | 8351 W Atlantic Blvd, Coral Springs, FL 33071-7454 | 2006-07-26 |
| 1720009848 | John S Bazos,d.m.d.,p.a. | Dentist | 9156 Wiles Rd, Coral Springs, FL 33067-1999 | 2006-07-22 |
| 1962010652 | Cl Dds 2 Pa | Dentist | 9156 Wiles Rd, Coral Springs, FL 33067-1999 | 2020-07-19 |
| 1134784267 | Mighty Children's Dentistry | Dentist | 5850 Coral Ridge Dr Ste 101b, Coral Springs, FL 33076-3379 | 2019-05-03 |
| Find all providers in CORAL SPRINGS | ||||
| City | CORAL SPRINGS |
| Zip Code | 33076 |
Please comment or provide details below to improve the information on CORAL DENTAL SPECIALISTS LLC.
| 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.