MEDICARE: SUNSHINE DENTAL GROUP 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
1	1223G0001X	General Practice Dentistry	DN 15219	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376610402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE DENTAL GROUP PA

Provider Business Mailing Address
First Line	:	1843 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-3417
Country	:	US
Telephone Number	:	305-643-3040
Fax Number	:

Provider Business Practice Location Address
First Line	:	1843 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-3417
Country	:	US
Telephone Number	:	305-643-3040
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	ARMANDO ORTEGA
Credential	:	DDS
Telephone Number	:	305-643-3040

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/22/2020

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Directions to “SUNSHINE DENTAL GROUP PA ” Practice Location

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