Healthcare Provider Details

I. General information

NPI: 1053731893
Provider Name (Legal Business Name): TIFFANY ABRISHAMIAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2014
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 NE 191ST ST STE 204
MIAMI FL
33180-3116
US

IV. Provider business mailing address

2999 NE 191ST ST STE 204
MIAMI FL
33180-3116
US

V. Phone/Fax

Practice location:
  • Phone: 305-466-1804
  • Fax:
Mailing address:
  • Phone: 305-466-1804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN29619
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number057934
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: