DENTAL SPECIALISTS OF HOMESTEAD NPI 1417592247

NPI Information

NPI: 1417592247
Provider Name: DENTAL SPECIALISTS OF HOMESTEAD
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
190 NW 14TH ST
HOMESTEAD, FL
ZIP 33030
Phone: (786) 355-4401
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DENTAL SPECIALISTS OF HOMESTEAD is a dental clinic center in Homestead, FL. DENTAL SPECIALISTS OF HOMESTEAD NPI is 1417592247. The provider is registered as an organization entity type.

The provider's business location address is:

190 NW 14TH ST
HOMESTEAD, FL
ZIP 33030-240
Phone: (786) 355-4401
Fax: (305) 220-9966

The provider's authorized official is Ivan Pelton .
The authorized official title is Administrative Operator and has the following contact phone number (305) 530-8115.

The enumeration date for this NPI number is 11/15/2019 and was last updated on 11/15/2019.

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	261QD0000X	Clinic/Center	Dental			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	P435417372860	OTHER	FLORIDA	DRIVERS LICENSE

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: 5/5/2024

NPI Synchronization or Removal

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