Healthcare Provider Details

I. General information

NPI: 1568249183
Provider Name (Legal Business Name): NOVALIZ DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 E 49TH ST UNIT 101
HIALEAH FL
33013-1966
US

IV. Provider business mailing address

710 E 49TH ST UNIT 101
HIALEAH FL
33013-1966
US

V. Phone/Fax

Practice location:
  • Phone: 281-865-5379
  • Fax:
Mailing address:
  • Phone: 786-687-0909
  • Fax: 786-687-0272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LISET MARIA FRIAS FIGUEREDO
Title or Position: DENTIST
Credential: DDS
Phone: 281-865-5379