Pembroke Dental & Spa PL

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PEMBROKE DENTAL & SPA PL

Practice address

15671 Pines Blvd
Pembroke Pines, FL 33027-1204

Phone

(954) 419-4455

NPI assigned

May 6, 2019

Organization subpart

No

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

Authorized official

Name

Jeanette Novara, DMD

Title

Authorized Official

Phone

(786) 488-3507

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1659936656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21239 NE 31ST AVE",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15671 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271204",
            "telephone_number": "954-419-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE DENTAL & SPA PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "NOVARA",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-488-3507",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Pelaez, RD
• Sophia Pelaez
• Melissa Rae Pelosi, PA
• Pemboke Family Denisty P.a.
• Pembrok Health and Wellness Center, LLC
• Pembroke Dental Associates
• Pembroke Lakes Mall Dental PA
• Pembroke Lakes Optical Inc
• Pembroke Pavilion Psychiatric Associates, Inc
• Pembroke Pines Accident & Injury Center, Inc.

• 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 May 6, 2019; 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.