BOYNTON BEACH MALL DENTAL PA (NPI# 1861053480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861053480 |
| Entity Type | Organization |
| Organization Name | BOYNTON BEACH MALL DENTAL PA |
| Practice Address |
801 N Congress Ave Ste 185d Boynton Beach FL 33426-3364 |
| Practice Telephone | 5613697199 |
| Mailing Telephone | 5613697199 |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |
| Authorized Official Name | ROSTISLAV KRASNOV (OWNER) |
| Authorized Official Telephone | 5613697199 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
801 N CONGRESS AVE STE 185D |
| City | BOYNTON BEACH |
| State | FL |
| Zip Code | 33426-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231690 | Gail J Laufer Inc | Clinic/Center | 1660 Ren. Commons Blvd, 2411, Boynton Beach, FL 33426 | 2020-06-30 |
| 1497399125 | Roots To Recovery, LLC | Substance Abuse Rehabilitation Facility | 514 Nw 7th Court, Boynton Beach, FL 33426 | 2019-11-06 |
| 1609429547 | Roman Health Pharmacy LLC | Pharmacy | 3602 Quantum Blvd, Boynton Beach, FL 33426 | 2019-07-19 |
| 1710457783 | Immersion Residential LLC | Substance Abuse Rehabilitation Facility | 900 N Congress Ave, Boynton Beach, FL 33426 | 2018-12-03 |
| 1013425727 | Latoya Camay Howell | Family Medicine | 1605 Renaissance Commons Blvd, 428, Boynton Beach, FL 33426 | 2018-01-16 |
| 1699292979 | Vitae Services of The Palm Beaches, Inc. | Home Health | 517 Industrail Ave., Boynton Beach, FL 33426 | 2017-08-28 |
| 1063933075 | Perla G Salazar | Dentist | 1690 Renaissance Commons Blvd Apt 1625, Boynton Beach, FL 33426 | 2017-06-29 |
| 1801339411 | Marianna Zadov, P.a | Dentist | 1301 N Congress Ave #110, Boyton Beach, FL 33426 | 2016-11-30 |
| 1366801334 | Medical Consultants of Florida | Non-Pharmacy Dispensing Site | 1485 Gateway Blvd Ste 102, Boynton Beach, FL 33426 | 2016-02-18 |
| 1396114443 | Beachway Therapy Center LLC | Substance Abuse Rehabilitation Facility | 2600 Quantum Blvd, Suite B, 1st Floor, Boynton Beach, FL 33426 | 2015-09-18 |
| Find all providers in zip 33426 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326843 | Stellar Smiles Inc. | Dentist | 1501 Corporate Dr Apt 311, Boynton Beach, FL 33426-6600 | 2020-11-07 |
| 1316429780 | Dental Arts of Boynton Beach | Dentist | 10150 Hagen Ranch Rd Ste 202, Boynton Beach, FL 33437-3776 | 2018-09-03 |
| 1780198978 | Procare Dentistry | Dentist | 3509 W. Boynton Beach Blvd, Boynton Beach, FL 33436 | 2017-11-27 |
| 1710409990 | Camilo Rodriguez | Dentist | 7593 W Boynton Beach Blvd Ste 200, Boynton Beach, FL 33437-6162 | 2017-07-10 |
| 1225558604 | Jacqueline Russo | Dentist | 11676 Dunes Rd, Boynton Beach, FL 33436-5503 | 2017-06-26 |
| 1467988253 | Susel Maria Perez Ojeda | Dentist | 8773 Boynton Beach Blvd Unit 520, Boynton Beach, FL 33472 | 2017-05-11 |
| 1780044149 | Charles John Lalane | Dentist | 832 Sw 36th Ave, Boynton Beach, FL 33435-8514 | 2016-02-28 |
| 1649679945 | Melissa Bowers | Dentist | 9851 S Military Trl Ste I, Boynton Beach, FL 33436-3205 | 2014-08-22 |
| 1104258417 | Domenick Andrew Cerullo | Dentist | 10150 Hagen Ranch Road Suite 202, Dental Arts of Boynton Beach, P.a., Boynton Beach, FL 33437 | 2013-08-09 |
| 1487955266 | Florida Dental & Denture Center | Dentist | 1901 S Federal Hwy, Boynton Beach, FL 33435-6904 | 2010-11-09 |
| Find all providers in BOYNTON BEACH | ||||
| City | BOYNTON BEACH |
| Zip Code | 33426 |
Please comment or provide details below to improve the information on BOYNTON BEACH MALL DENTAL PA.
| 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.