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PEMBROKE LAKES MALL DENTAL PA
NPI 1144945882
Dentist - General Practice in Pembroke Pines, FL

Active since October 05, 2022
11401 PINES BLVD STE 220, PEMBROKE PINES, FL 33026(954) 573-1400 Get Directions Write a Review

NPPES record last updated: October 12, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2022, Oct 6, 2022 (2 updates tracked since 2022).

About Pembroke Lakes Mall Dental Pa NPPES

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

PEMBROKE LAKES MALL DENTAL PA (NPI 1144945882) is a healthcare organization registered as a general practice in Pembroke Pines, Florida and active in the NPI registry since October 2022. The organization lists Rostislav Krasnov, Owner, as its authorized official.

NPPES Registry Identity

NPI1144945882
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePEMBROKE LAKES MALL DENTAL PA
Location Address11401 PINES BLVD STE 220Pembroke Pines, FL 33026-4104
Mailing Address11401 Pines Blvd Ste 220Pembroke Pines, FL 33026-4104
Phone(954) 573-1400
Organization SubpartNo
Authorized OfficialRostislav KrasnovOwner · (954) 573-1400
Enumeration DateOctober 5, 2022
Last NPPES UpdateOctober 12, 20222 updates tracked since enumeration
NPPES CertifiedOctober 12, 2022
✔ NPI 1144945882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, DentaQuest Insurance Company, Inc..Insurance ›

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.

LAKES MALL DENTAL CENTER , PA
Dentist (General Practice)
11401 PINES BLVD STE 220
PEMBROKE PINES, FL 33026
Broward County (954) 432-5515
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 Pembroke Lakes Mall Dental PA's NPI number?

The NPI number for Pembroke Lakes Mall Dental PA is 1144945882. It was assigned to this organization in the NPPES registry on October 5, 2022.

Where is Pembroke Lakes Mall Dental PA located?

Pembroke Lakes Mall Dental PA is located at 11401 Pines Blvd Ste 220, Pembroke Pines, FL 33026. The listed phone number is (954) 573-1400.

What is Pembroke Lakes Mall Dental PA's specialty?

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

What insurance does Pembroke Lakes Mall Dental PA accept?

Health plans from Ambetter Health, Ambetter of Alabama and DentaQuest Insurance Company, Inc. list Pembroke Lakes Mall Dental PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pembroke Lakes Mall Dental PA was last updated on October 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.