Healthcare Provider Details

I. General information

NPI: 1164355921
Provider Name (Legal Business Name): ARLETIS MARIA FERNANDEZ DOMINGUEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13148 SW 91ST PL
MIAMI FL
33176-5837
US

IV. Provider business mailing address

13148 SW 91ST PL
MIAMI FL
33176-5837
US

V. Phone/Fax

Practice location:
  • Phone: 786-414-7388
  • Fax:
Mailing address:
  • Phone: 786-414-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31747
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: