Healthcare Provider Details

I. General information

NPI: 1346297082
Provider Name (Legal Business Name): MAX NAHON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

1169 99TH ST
BAY HARBOR ISLANDS FL
33154-1718
US

V. Phone/Fax

Practice location:
  • Phone: 542-624-3459
  • Fax:
Mailing address:
  • Phone: 706-877-7901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN012097
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN17437
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: