Pembroke Dental & Spa Pl
Clinic/Center, Dental in Pembroke Pines, FL. Organization (NPI-2).
NPI number1659936656
StatusActive
Last updated in NPPESMay 6, 2019
Details
- NPI
- 1659936656
- Entity type
- Organization (NPI-2)
- Legal business name
- Pembroke Dental & Spa Pl
- Organization subpart
- No
- Enumeration date
- May 6, 2019
- Last updated
- May 6, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
15671 Pines BlvdPembroke Pines, FL 33027-1204
Phone 954-419-4455
Mailing address
21239 Ne 31st AveAventura, FL 33180-3907
Authorized official
Jeanette Novara
Authorized Official
7864883507
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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