Healthcare Provider Details

I. General information

NPI: 1720891401
Provider Name (Legal Business Name): LHA SMILES DESIGN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4980 W 10TH AVE
HIALEAH FL
33012-3437
US

IV. Provider business mailing address

7500 SW 8TH ST STE 400
MIAMI FL
33144-4400
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-0866
  • Fax:
Mailing address:
  • Phone:
  • 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: LUIS HERNANDEZ-ABREU
Title or Position: OWNER
Credential:
Phone: 305-910-9817