FUNCTIONAL FACIAL ORTHOPEDICS NPI 1407207194

NPI Information

NPI: 1407207194
Provider Name: FUNCTIONAL FACIAL ORTHOPEDICS
Classification: Dentist - 1223S0112X
Specialization: Oral and Maxillofacial Surgery
Entity Type: Organization
Address: 13421 S SHORE BLVD
SUITE 203
WELLINGTON, FL
ZIP 33414
Phone: (561) 215-1603

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NPI Details

FUNCTIONAL FACIAL ORTHOPEDICS is an oral and maxillofacial surgery dentist in Wellington, FL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. FUNCTIONAL FACIAL ORTHOPEDICS NPI is 1407207194. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13421 S SHORE BLVD
SUITE 203
WELLINGTON, FL
ZIP 33414-210
Phone: (561) 215-1603
Fax: (561) 537-5738

The provider's authorized official is Nilsa H Toledo .
The authorized official title is President/owner and has the following contact phone number (561) 215-1603.

The enumeration date for this NPI number is 6/24/2016 and was last updated on 6/24/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D17401	OTHER	FLORIDA	MEDICAL LICENSE NUMBER
2	075862100	MEDICAID	FLORIDA

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: 11/21/2025

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