American Pediatric Dental Pines LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

AMERICAN PEDIATRIC DENTAL PINES LLC

Practice address

18501 Pines Blvd Ste 211
Pembroke Pines, FL 33029-1420

Phone

(954) 417-1337

Fax

(954) 417-1338

NPI assigned

Jun 19, 2017

Last updated

Jul 21, 2022By 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

Richelle Pena

Title

Director of Corporate

Phone

(415) 518-5117

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508396847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18501 PINES BLVD STE 211",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291420",
            "telephone_number": "954-417-1337",
            "fax_number": "954-417-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18501 PINES BLVD STE 211",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291420",
            "telephone_number": "954-417-1337",
            "fax_number": "954-417-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN PEDIATRIC DENTAL PINES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "RICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF CORPORATE",
        "authorized_official_telephone_number": "415-518-5117"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.