MEDICARE: DR. DAVID ROBERT QUINTANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN27581	FL
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN124053	GA

General Provider Information

NPI Number	:	1053299826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ROBERT QUINTANA

Provider Business Mailing Address
First Line	:	8335 SW 157TH ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-2165
Country	:	US
Telephone Number	:	305-586-5342
Fax Number	:

Provider Business Practice Location Address
First Line	:	5495 OLD NATIONAL HWY
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-3252
Country	:	US
Telephone Number	:	470-441-7874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	01/20/2026

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