Healthcare Provider Details

I. General information

NPI: 1437996840
Provider Name (Legal Business Name): ELI OPPENHEIMER DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 NAUTILUS DR
MIAMI BEACH FL
33140-2821
US

IV. Provider business mailing address

4213 NAUTILUS DR
MIAMI BEACH FL
33140-2821
US

V. Phone/Fax

Practice location:
  • Phone: 786-390-8042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELI OPPENHEIMER
Title or Position: ORAL AND MAXILLOFACIAL SURGEON
Credential:
Phone: 786-390-8042