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CORAL RIDGE SMILE NPI 1689794505


NPI Information

NPI: 1689794505
Provider Name: CORAL RIDGE SMILE
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 10D1088107

Address:
2324 NE 53RD ST
FT LAUDERDALE, FL
ZIP 33308
Phone: (954) 990-6543
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CORAL RIDGE SMILE is a general practice dentist in Ft Lauderdale, FL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CORAL RIDGE SMILE NPI is 1689794505. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2324 NE 53RD ST
FT LAUDERDALE, FL
ZIP 33308-212
Phone: (954) 990-6543
Fax: (954) 491-4876

The provider's authorized official is Mandana Mir Esmaili .
The authorized official title is Owner and has the following contact phone number (954) 990-6543.

The CLIA number assigned to this NPI record is 10D1088107 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 2/16/2012.


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
11223G0001XDentistGeneral PracticeYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.