1. Home
  2. Directory
  3. Florida
  4. Pembroke Pines
  5. Dentist
  6. NPI Profile

PINES DENTAL VILLAGE CORP.
NPI 1205706074
Dentist - General Practice in Pembroke Pines, FL

Active since November 07, 2025
12558 PINES BLVD, PEMBROKE PINES, FL 33027(954) 639-6998 Get Directions Write a Review

NPPES record last updated: November 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pines Dental Village Corp. NPPES

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

PINES DENTAL VILLAGE CORP. (NPI 1205706074) is a healthcare organization registered as a general practice in Pembroke Pines, Florida and active in the NPI registry since November 2025. The organization lists Liveisys Pedraza, Owner, as its authorized official.

NPPES Registry Identity

NPI1205706074
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePINES DENTAL VILLAGE CORP.
Location Address12558 PINES BLVDPembroke Pines, FL 33027-1713
Mailing Address12558 Pines BlvdPembroke Pines, FL 33027-1713 · (954) 639-6998
Phone(954) 639-6998
Organization SubpartNo
Authorized OfficialLiveisys PedrazaOwner · (786) 337-1013
Enumeration DateNovember 7, 2025
NPPES CertifiedNovember 7, 2025
✔ NPI 1205706074 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.
12558 PINES BLVD, Pembroke Pines, FL 33027
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

DENTAL SPECIALISTS OF PEMBROKE PINES GROUP
Dentist (General Practice)
12558 PINES BLVD
PEMBROKE PINES, FL 33027
Broward County (305) 220-8911

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 Pines Dental Village Corp.'s NPI number?

The NPI number for Pines Dental Village Corp. is 1205706074. It was assigned to this organization in the NPPES registry on November 7, 2025.

Where is Pines Dental Village Corp. located?

Pines Dental Village Corp. is located at 12558 Pines Blvd, Pembroke Pines, FL 33027. The listed phone number is (954) 639-6998.

What is Pines Dental Village Corp.'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 Pines Dental Village Corp. was last updated on November 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.