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NPI Code Detail

MEDICARE: PHANORD & ASSOCIATES PA

MEDICARE: PHANORD & ASSOCIATES PA
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
11223P0221XPediatric DentistryDN0014809FL
21223E0200XEndodonticsDN0011339FL
31223S0112XOral and Maxillofacial Surgery (Dentist)DN0011236FL

General Provider Information

NPI Number : 1255362877
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHANORD & ASSOCIATES PA
Provider Business Mailing Address
First Line : 1245 NW 119 ST
Second Line :
City : MIAMI
State : FL
Zip : 33167
Country : US
Telephone Number : 305-685-7863
Fax Number : 305-687-7603
Provider Business Practice Location Address
First Line : 1245 NW 119 ST
Second Line :
City : MIAMI
State : FL
Zip : 33167
Country : US
Telephone Number : 305-685-7863
Fax Number : 305-687-7603
Authorized Official
Title or Position : OWNER AND DOCTOR
Name : DR. ROGER J PHANOD
Credential : DMD
Telephone Number : 305-685-7863
Provider Enumeration Date : 07/05/2006
Last Update Date : 09/11/2025

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Directions to “PHANORD & ASSOCIATES PA ” Practice Location

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