PEMBROKE PINES PEDIATRIC DENTISTRY (NPI# 1942424700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942424700 |
| Entity Type | Organization |
| Organization Name | PEMBROKE PINES PEDIATRIC DENTISTRY |
| Practice Address |
12311 Taft St Ste 3 Pembroke Pines FL 33026-4384 |
| Practice Telephone | 9544317199 |
| Practice Fax Number | 9544319102 |
| Mailing Telephone | 9544317199 |
| Mailing Fax Number | 9544319102 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2010-10-18 |
| Authorized Official Name | DR. JUAN LUIS GARRASTAZU (PRESIDENT) |
| Authorized Official Telephone | 9544317199 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
FL | Dental Providers |
| Street Address |
12311 TAFT ST STE 3 |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33026-4384 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811488398 | Nathanel A Shammay | Student in an Organized Health Care Education/Training Program | 11251 Renaissance Rd, Cooper City, FL 33026 | 2018-05-21 |
| 1245741313 | Isabel C Gomez | Behavior Technician | 1300 St Charles Place, Pembroke Pines, FL 33026 | 2017-10-17 |
| 1376052233 | Natalie Valentine | Psychologist | 11749 Nw 12th St, Pembroke Pines, FL 33026 | 2017-09-23 |
| 1285159178 | Belkis Perez | Optometrist | 11605 Pines Blvd., Pembroke Pines, FL 33026 | 2017-08-11 |
| 1447792429 | Merlin Abraham | Physical Therapy Assistant | 10794 Pines Blvd #104, Pembroke Pines, FL 33026 | 2016-11-08 |
| 1588024285 | Kerryrose Joyceann Gordon | Registered Nurse | 600 North Hiatus Road, Suite 102, Pembroke Pines, FL 33026 | 2016-02-24 |
| 1659745149 | Grand Dialysis Services LLC | Clinic/Center | 500 N. Hiatus Road, Suite 105, Pembroke Pines, FL 33026 | 2015-11-20 |
| 1992107999 | Therapies 4 Kids, Inc. | Clinic/Center | 1311-1321 N. Palm Avenue, Pembroke Pines, FL 33026 | 2014-09-22 |
| 1073940631 | Lisa Margo Guertin | Nurse Practitioner | 10836 Morningstar Drive, Hollywood, FL 33026 | 2013-09-27 |
| 1881930865 | Carol Elizabeth Farrell | Speech-Language Pathologist | 11704 Melaleuca Way, Cooper City, FL 33026 | 2012-12-20 |
| Find all providers in zip 33026 | ||||
| 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 |
|---|---|---|---|---|
| 1891049557 | Richard L. Sherman, Dds. | Dentist | 2249 N. University Drive, Pembroke Pines, FL 33024 | 2012-11-02 |
| 1306904164 | Richard Louis Sherman | Dentist | 2249 N University Dr, Pembroke Pines, FL 33024-3611 | 2006-12-05 |
| 1982772877 | Helena Urrea-feldsberg | Dentist | 160 N University Dr, Pembroke Pines, FL 33024-6714 | 2006-12-01 |
| 1770660508 | Sam Eisenstein | Dentist | 12333 Nw 18th Street, Suite 4, Pembroke Pines, FL 33026-4386 | 2006-11-01 |
| 1487759338 | Stephen H Wander | Dentist | 12301 Taft St, #300, Pembroke Pines, FL 33026-4387 | 2006-09-14 |
| 1508396847 | American Pediatric Dental Pines LLC | Dentist | 18501 Pines Blvd Ste 211, Pembroke Pines, FL 33029-1420 | 2017-06-19 |
| 1295269116 | Jacaranda Smiles West | Dentist | 18503 Pines Blvd, Suite 209, Pembroke Pines, FL 33029-1404 | 2017-04-18 |
| 1043677925 | Jacaranda Smiles East | Dentist | 10051 Pines Blvd, Suite C, Pembroke Pines, FL 33024-6186 | 2016-01-22 |
| 1619362209 | Patricia Gonzalez Templeton D.d.s, LLC | Dentist | 2249 N University Dr, Pembroke Pines, FL 33024-3611 | 2015-04-01 |
| 1720374838 | William A. Pena Dmd, Pa | Dentist | 10021 Pines Blvd, Suite 100, Pembroke Pines, FL 33024-6191 | 2011-06-27 |
| Find all providers in PEMBROKE PINES | ||||
| City | PEMBROKE PINES |
| Zip Code | 33026 |
Please comment or provide details below to improve the information on PEMBROKE PINES PEDIATRIC DENTISTRY.
| 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.