PEMBROKE DENTAL ASSOCIATES (NPI# 1154694891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154694891 |
| Entity Type | Organization |
| Organization Name | PEMBROKE DENTAL ASSOCIATES |
| Practice Address |
12251 Taft St Suite 404 Pembroke Pines FL 33026-1901 |
| Practice Telephone | 9544327077 |
| Practice Fax Number | 9544330748 |
| Mailing Telephone | 9544327077 |
| Mailing Fax Number | 9544330748 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |
| Authorized Official Name | DR. EDGAR J PORRAS (PRESIDENT) |
| Authorized Official Telephone | 9544327077 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DN11671 | FL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001313400 | 05 |
| Street Address |
12251 TAFT ST SUITE 404 |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33026-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487692075 | Sleep Metrics, Inc | Clinic/Center | 12251 Taft St, Pembroke Pines, FL 33026-1956 | 2006-06-03 |
| 1538727516 | 360 Rehab Services Inc. | Clinic/Center | 12251 Taft St, Pembroke Pines, FL 33026-1901 | 2019-06-04 |
| 1043704026 | Reshma Baddaloo | Dentist | 12251 Taft St, Pembroke Pines, FL 33026-1901 | 2018-06-21 |
| 1033507520 | Superior Nurse Partners LLC | Nursing Care | 12251 Taft St, Suite 302, Pembroke Pines, FL 33026-1901 | 2015-01-06 |
| 1346647781 | Floridan Dental At Pines, Pllc | Dentist | 12251 Taft St, Suite 200, Pembroke Pines, FL 33026-1901 | 2014-12-01 |
| 1881010585 | Richard C Zang | Acupuncturist | 12251 Taft St, Suite #303, Pembroke Pines, FL 33026-1901 | 2014-03-05 |
| 1437455284 | Michaela Marina Hernandez | Physician Assistant | 12251 Taft St, Suite 401, Pembroke Pines, FL 33026-1901 | 2011-01-26 |
| 1528398922 | Seredor Centers Inc | Clinic/Center | 12251 Taft St, Suite 403, Pembroke Pines, FL 33026-1901 | 2010-01-06 |
| 1295060010 | Sleep Florida LLC | Psychiatry & Neurology | 12251 Taft St, Suite 300, Pembroke Pines, FL 33026-1901 | 2009-10-13 |
| 1346489507 | Center for Gastroenterology P A | Internal Medicine | 12251 Taft St, Suite 301, Pembroke Pines, FL 33026-1901 | 2009-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811488398 | Nathanel A Shammay | Student in an Organized Health Care Education/Training Program | 11251 Renaissance Rd, Cooper City, FL 33026 | 2018-05-21 |
| 1245741313 | Isabel C Gomez | Behavior Technician | 1300 St Charles Place, Pembroke Pines, FL 33026 | 2017-10-17 |
| 1376052233 | Natalie Valentine | Psychologist | 11749 Nw 12th St, Pembroke Pines, FL 33026 | 2017-09-23 |
| 1285159178 | Belkis Perez | Optometrist | 11605 Pines Blvd., Pembroke Pines, FL 33026 | 2017-08-11 |
| 1447792429 | Merlin Abraham | Physical Therapy Assistant | 10794 Pines Blvd #104, Pembroke Pines, FL 33026 | 2016-11-08 |
| 1588024285 | Kerryrose Joyceann Gordon | Registered Nurse | 600 North Hiatus Road, Suite 102, Pembroke Pines, FL 33026 | 2016-02-24 |
| 1659745149 | Grand Dialysis Services LLC | Clinic/Center | 500 N. Hiatus Road, Suite 105, Pembroke Pines, FL 33026 | 2015-11-20 |
| 1992107999 | Therapies 4 Kids, Inc. | Clinic/Center | 1311-1321 N. Palm Avenue, Pembroke Pines, FL 33026 | 2014-09-22 |
| 1073940631 | Lisa Margo Guertin | Nurse Practitioner | 10836 Morningstar Drive, Hollywood, FL 33026 | 2013-09-27 |
| 1881930865 | Carol Elizabeth Farrell | Speech-Language Pathologist | 11704 Melaleuca Way, Cooper City, FL 33026 | 2012-12-20 |
| Find all providers in zip 33026 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669932844 | Sean Donovan Mccall | Dentist | 2221 N University Dr Ste D, Pembroke Pines, FL 33024-3603 | 2019-03-22 |
| 1912082868 | Edward Ronald Kirsh | Dentist | 3 Sw 129th Ave, Ste 205, Pembroke Pines, FL 33027 | 2006-10-26 |
| 1235243189 | Ivan Pelton | Dentist | 12558 Pines Blvd, Pembroke Pines, FL 33027-1713 | 2006-08-18 |
| 1003832528 | Joel Brian Slingbaum | Dentist | 2221 N University Dr, Suite D, Pembroke Pines, FL 33024-3603 | 2006-07-15 |
| 1669967816 | Lauren Tink | Dentist | 10430 Pines Blvd Ste C103, Pembroke Pines, FL 33026-6049 | 2018-06-28 |
| 1427500610 | Endo Group Pllc | Dentist | 3 Sw 129th Ave, Ste 205, Pembroke Pines, FL 33027-1775 | 2016-11-04 |
| 1639560543 | Fredericka Salbo | Dentist | 2221 N University Dr, Pembroke Pines, FL 33024-3603 | 2015-02-13 |
| 1205167673 | Timur A Sekercioglu | Dentist | 18044 Nw 6th St, Suite 103, Pembroke Pines, FL 33029-2824 | 2010-01-24 |
| 1013164060 | Laura Gonzalez D.m.d, P.a. | Dentist | 500 N Hiatus Rd, Suite 109, Pembroke Pines, FL 33026-5213 | 2008-08-21 |
| 1447455225 | Shahbod Rassoulian | Dentist | 11401 Pines Blvd, Suite 220, Pembroke Pines, FL 33026 | 2007-06-20 |
| Find all providers in PEMBROKE PINES | ||||
| City | PEMBROKE PINES |
| Zip Code | 33026 |
Please comment or provide details below to improve the information on PEMBROKE DENTAL ASSOCIATES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.