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CHILDRENS DENTISTRY OF THE PALM BEACHES NPI 1205104809


NPI Information

NPI: 1205104809
Provider Name: CHILDRENS DENTISTRY OF THE PALM BEACHES
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
3365 BURNS RD STE 209
PALM BEACH GARDENS, FL
ZIP 33410
Phone: (561) 775-1011
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CHILDRENS DENTISTRY OF THE PALM BEACHES is a pediatric dentistry dentist in Palm Beach Gardens, FL. The provider is 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. CHILDRENS DENTISTRY OF THE PALM BEACHES NPI is 1205104809. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3365 BURNS RD STE 209
PALM BEACH GARDENS, FL
ZIP 33410-308
Phone: (561) 775-1011
Fax: (561) 775-8283

The provider's authorized official is Yuri Goldvasser .
The authorized official title is President and has the following contact phone number (561) 775-1011.

The enumeration date for this NPI number is 12/9/2011 and was last updated on 12/9/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric DentistryDN16968FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1076153200MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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