Andrew Peloquin, DMD
Individual provider Active NPI General Practice Dentistry · Golf, FL
NPI 1821781667 · NPPES record last updated May 29, 2023
Key facts
- NPI
- 1821781667
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN27922 (FL)
- Practice address
- 11800 S Military TRL Ste 102
Golf, FL 33436-5501 - Phone
- (401) 241-0310
- NPI assigned
- May 29, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN27922 | FL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN27922 | FL | Yes |
Addresses
Primary practice location
11800 S Military TRL Ste 102
Golf, FL 33436-5501
Mailing address
5201 W Hillsboro Blvd # 201
Coconut Creek, FL 33073-4401
Other providers in Golf, FL
All providers in Golf, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.