Lakes Mall Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LAKES MALL DENTAL

Practice address

11401 Pines Blvd
Ste 220
Pembroke Pines, FL 33026-4117

Phone

(954) 432-5515

Fax

(954) 432-8908

NPI assigned

Sep 24, 2007

Organization subpart

No

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

Authorized official

Name

Ronald L Sloane, DDS

Title

Owner

Phone

(954) 432-5515

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1609062686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 PINES BLVD",
            "address_2": "STE 220",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264117",
            "telephone_number": "954-432-5515",
            "fax_number": "954-432-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 PINES BLVD",
            "address_2": "STE 220",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264117",
            "telephone_number": "954-432-5515",
            "fax_number": "954-432-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES MALL DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "SLOANE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-432-5515",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laguna Isles Dental, LLC
• Tania Lahera Sanchez, APRN
• Charmaine P Laing, MD
• Navid Lajevardi, DMD
• Lidie Lajoie, M.D.
• Lakes Mall Dental Center , PA
• Lakeside Med LLC
• Lakeside Medical and Aesthetic Centre LC
• Lakeside Medical LLC
• Habeeb Ali Lakhani, M.D.

• Dental Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.