Healthcare Provider Details

I. General information

NPI: 1770418642
Provider Name (Legal Business Name): OMNIDENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N FEDERAL HWY UNIT 102
HALLANDALE BEACH FL
33009-3899
US

IV. Provider business mailing address

9800 W BAY HARBOR DR APT 610
BAY HARBOR ISLANDS FL
33154-1567
US

V. Phone/Fax

Practice location:
  • Phone: 754-816-1965
  • Fax:
Mailing address:
  • Phone: 845-545-1833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. INNA MICHNIK
Title or Position: OWNER
Credential:
Phone: 786-737-0033