Pines Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN001496 Issued in FL

Legal business name

PINES FAMILY DENTAL

Practice address

20170 Pines Blvd Ste 108
Pembroke Pines, FL 33029-1202

Phone

(954) 430-1717

Fax

(954) 430-3049

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Raul Lizaso, DMDNPI 1912005778

Title

Owner

Phone

(954) 430-1717

Specialties & licenses 1

Addresses

Other names 1

• Dr. Raul Lizaso Other name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raul Lizaso, DMD

  • General Practice Dentistry
  • Pembroke Pines, FL
  • NPI 1912005778
  NPD (past) Authorized official
• Frederick David Hart, DMD

  • General Practice Dentistry
  • Pembroke Pines, FL
  • NPI 1518124569
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962556514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20170 PINES BLVD STE 108",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291202",
            "telephone_number": "954-430-1717",
            "fax_number": "954-430-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20170 PINES BLVD STE 108",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291202",
            "telephone_number": "954-430-1717",
            "fax_number": "954-430-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINES FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIZASO",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-430-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN001496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Raul Lizaso",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Pines Dental Associates Inc
• Pines Dental Care, Inc
• Pines Dental Village Corp.
• Pines Diagnostic Testing Group Inc
• Pines Discount Pharmacy Inc
• Pines Foot & Ankle Surgical Group, Inc.
• Pines Imaging Center LLC
• Pines Injury Center, Inc.
• Pines Lymphatic Center LLC
• Pines Medical Center P a

• 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 Aug 22, 2020; 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.