Healthcare Provider Details

I. General information

NPI: 1043963788
Provider Name (Legal Business Name): LHA SMILES DESIGN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 01/26/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12615 W DIXIE HWY
NORTH MIAMI FL
33161-4803
US

IV. Provider business mailing address

7500 SW 8TH ST STE 400
MIAMI FL
33144-4400
US

V. Phone/Fax

Practice location:
  • Phone: 786-228-8295
  • Fax:
Mailing address:
  • Phone: 305-534-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUIS HERNANDEZ-ABREU
Title or Position: DENTIST
Credential: DMD
Phone: 305-910-9817