Healthcare Provider Details

I. General information

NPI: 1528793791
Provider Name (Legal Business Name): AREFEH ESKANDARI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 N FEDERAL HWY
POMPANO BEACH FL
33064-6738
US

IV. Provider business mailing address

9457 NW 11TH ST
PLANTATION FL
33322-4840
US

V. Phone/Fax

Practice location:
  • Phone: 954-531-0809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN122961
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN27303
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: