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PEDIATRIC & GENERAL DENTISTRY OF PALM BEACH PA NPI 1235698556


NPI Information

NPI: 1235698556
Provider Name: PEDIATRIC & GENERAL DENTISTRY OF PALM BEACH, PA
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

CLIA Number: 10D2286425

Address:
1620 S CONGRESS AVE STE 102
PALM SPRINGS, FL
ZIP 33461
Phone: (617) 770-0955
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PEDIATRIC & GENERAL DENTISTRY OF PALM BEACH, PA is a pediatric dentistry dentist in Palm Springs, FL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDIATRIC & GENERAL DENTISTRY OF PALM BEACH, PA NPI is 1235698556. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1620 S CONGRESS AVE STE 102
PALM SPRINGS, FL
ZIP 33461-128
Phone: (617) 770-0955

The provider's authorized official is Liliem Socarras Diaz .
The authorized official title is Pediatric Dentist and has the following contact phone number (561) 508-5930.

The CLIA number assigned to this NPI record is 10D2286425 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2019 and was last updated on 7/17/2020.


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
11223G0001XDentistGeneral PracticeNo
21223P0221XDentistPediatric DentistryYes

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: 5/5/2024

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.