Healthcare Provider Details

I. General information

NPI: 1417047218
Provider Name (Legal Business Name): REGINA H. SAENZ DDS, PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N KROME AVE STE 204
HOMESTEAD FL
33030-4455
US

IV. Provider business mailing address

4514 ALHAMBRA CIR
CORAL GABLES FL
33146-1016
US

V. Phone/Fax

Practice location:
  • Phone: 305-245-6633
  • Fax: 305-245-9633
Mailing address:
  • Phone: 305-666-9493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN15235
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: