Healthcare Provider Details

I. General information

NPI: 1174452692
Provider Name (Legal Business Name): BAYFRONT FAMILY DENTAL PA DBA BAYFRONT DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SE 1ST ST
MIAMI FL
33131-1902
US

IV. Provider business mailing address

224 SE 1ST ST
MIAMI FL
33131-1902
US

V. Phone/Fax

Practice location:
  • Phone: 305-530-1866
  • Fax: 305-577-7540
Mailing address:
  • Phone: 305-530-1866
  • Fax: 305-577-7540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. TAYLOR M LIGHT
Title or Position: DENTIST/PRESIDENT
Credential: DDS
Phone: 305-530-1866