MEDICARE: MENEKSE DENTAL PLLC

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

General Provider Information

NPI Number	:	1972448074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENEKSE DENTAL PLLC

Provider Business Mailing Address
First Line	:	3313 W COMMERCIAL BLVD STE 130
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33309-3413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3313 W COMMERCIAL BLVD STE 130
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33309-3413
Country	:	US
Telephone Number	:	617-749-6718
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CEM MENEKSE
Credential	:	DMD
Telephone Number	:	617-749-6718

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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