MEDICARE: LA DENTAL LLC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1568333839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA DENTAL LLC

Provider Business Mailing Address
First Line	:	2405 TARPON BAY BLVD UNIT 4
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-8763
Country	:	US
Telephone Number	:	702-327-1075
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 TARPON BAY BLVD UNIT 4
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-8763
Country	:	US
Telephone Number	:	702-327-1075
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUIS ALVERT
Credential	:
Telephone Number	:	702-327-1075

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	02/27/2026

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Directions to “LA DENTAL LLC ” Practice Location

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