Healthcare Provider Details

I. General information

NPI: 1285289777
Provider Name (Legal Business Name): KIMBERLY ELIZABETH MYONES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ELIZABETH BAUMGARDNER DMD

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 LAKE WORTH RD
LAKE WORTH BEACH FL
33461-4228
US

IV. Provider business mailing address

8693 WINDY CIR
BOYNTON BEACH FL
33472-5126
US

V. Phone/Fax

Practice location:
  • Phone: 561-277-3150
  • Fax:
Mailing address:
  • Phone: 619-972-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.025864
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN28789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: