LAKES MALL DENTAL NPI 1609062686

NPI Information

  • NPI: 1609062686
  • Provider Name: LAKES MALL DENTAL
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 11401 PINES BLVD
    STE 220
    PEMBROKE PINES, FL
    ZIP 33026
  • Phone: (954) 432-5515

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NPI Details

LAKES MALL DENTAL is a dental clinic center in Pembroke Pines, FL. LAKES MALL DENTAL NPI is 1609062686. The provider is registered as an organization entity type.

The provider's business location address is:

11401 PINES BLVD
STE 220
PEMBROKE PINES, FL
ZIP 33026-117
Phone: (954) 432-5515
Fax: (954) 432-8908

The provider's authorized official is Ronald L Sloane .
The authorized official title is Owner and has the following contact phone number (954) 432-5515.

The enumeration date for this NPI number is 9/24/2007 and was last updated on 9/24/2007.

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
1261QD0000XClinic/CenterDentalYes

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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