Pines Dental Village Corp.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PINES DENTAL VILLAGE CORP.

Practice address

12558 Pines Blvd
Pembroke Pines, FL 33027-1713

Phone

(954) 639-6998

NPI assigned

Nov 7, 2025

Last updated

Nov 7, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Liveisys Pedraza, DDS

Title

Owner

Phone

(786) 337-1013

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1205706074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12558 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271713",
            "telephone_number": "954-639-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12558 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271713",
            "telephone_number": "954-639-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINES DENTAL VILLAGE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "PEDRAZA",
        "authorized_official_first_name": "LIVEISYS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-337-1013",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pines Cardiology Inc
• Pines Care Medical Center, LLC
• Pines Chiromed Center, LLC (South Florida Spine and Rehab Centers)
• Pines Dental Associates Inc
• Pines Dental Care, Inc
• Pines Diagnostic Testing Group Inc
• Pines Discount Pharmacy Inc (Aloe Drug Mart)
• Pines Family Dental
• Pines Foot & Ankle Surgical Group, Inc.
• Pines Imaging Center LLC

• General Practice Dentistry in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.