Healthcare Provider Details

I. General information

NPI: 1790818722
Provider Name (Legal Business Name): VICTORIA LAOR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA TSIMBERG DDS

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W 16TH AVE STE 52
HIALEAH FL
33012-7193
US

IV. Provider business mailing address

8925 COLLINS AVE APT 2A
SURFSIDE FL
33154-3531
US

V. Phone/Fax

Practice location:
  • Phone: 305-825-9899
  • Fax:
Mailing address:
  • Phone: 302-383-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number054324
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number054324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: