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LAKES MALL DENTAL CENTER , PA
NPI 1063757912
Dentist - General Practice in Pembroke Pines, FL

Active since December 04, 2012
11401 PINES BLVD STE 220, PEMBROKE PINES, FL 33026(954) 432-5515 Get Directions Write a Review

NPPES record last updated: December 4, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lakes Mall Dental Center , Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKES MALL DENTAL CENTER , PA (NPI 1063757912) is a healthcare organization registered as a general practice in Pembroke Pines, Florida and active in the NPI registry since December 2012. The organization lists Erik O Calderon, President, as its authorized official.

NPPES Registry Identity

NPI1063757912
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameLAKES MALL DENTAL CENTER , PA
Location Address11401 PINES BLVD STE 220Pembroke Pines, FL 33026-4104
Mailing Address1830 S Ocean Dr Apt 2204Hallandale Beach, FL 33009-7695 · (305) 951-9988
Phone(954) 432-5515
Organization SubpartNo
Authorized OfficialErik O CalderonPresident · (305) 951-9988
Enumeration DateDecember 4, 2012
✔ NPI 1063757912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in FL · 19377
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
11401 PINES BLVD STE 220, Pembroke Pines, FL 33026
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEMBROKE LAKES MALL DENTAL PA
Dentist (General Practice)
11401 PINES BLVD STE 220
PEMBROKE PINES, FL 33026
Broward County (954) 573-1400
MARIA ESTHER LOPEZ
Dentist
11401 PINES BLVD STE 220
PEMBROKE PINES, FL 33026
Broward County (954) 432-5515
DR. GREYT NOVO GARCIA
Dentist (General Practice)
11401 PINES BLVD STE 220
PEMBROKE PINES, FL 33026
Broward County (954) 573-1400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakes Mall Dental Center , PA's NPI number?

The NPI number for Lakes Mall Dental Center , PA is 1063757912. It was assigned to this organization in the NPPES registry on December 4, 2012.

Where is Lakes Mall Dental Center , PA located?

Lakes Mall Dental Center , PA is located at 11401 Pines Blvd Ste 220, Pembroke Pines, FL 33026. The listed phone number is (954) 432-5515.

What is Lakes Mall Dental Center , PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Lakes Mall Dental Center , PA was last updated on December 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.