Healthcare Provider Details

I. General information

NPI: 1447115019
Provider Name (Legal Business Name): PERFECT SMILE AT DADELAND CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 74TH CT STE 1201
MIAMI FL
33156-3170
US

IV. Provider business mailing address

8950 SW 74TH CT STE 1201
MIAMI FL
33156-3170
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-3147
  • Fax:
Mailing address:
  • Phone: 305-456-3147
  • Fax:

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: LIVEISYS PEDRAZA
Title or Position: OWNER
Credential: DDS
Phone: 305-456-3157