Healthcare Provider Details

I. General information

NPI: 1528134244
Provider Name (Legal Business Name): LIANA BASCEANU-SARBU D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SOUTH UNIVERSITY DRIVE
FORT LAUDERDALE FL
33328
US

IV. Provider business mailing address

1945 S OCEAN DRIVE APT 1414
HALLANDALE BEACH FL
33009
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-1691
  • Fax: 954-262-1782
Mailing address:
  • Phone: 201-888-3867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI01842600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: