Healthcare Provider Details

I. General information

NPI: 1538037759
Provider Name (Legal Business Name): FOUNDATION FIRST AIRWAY CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3790 7TH TER STE 101
VERO BEACH FL
32960-6552
US

IV. Provider business mailing address

3790 7TH TER STE 101
VERO BEACH FL
32960-6552
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-4118
  • Fax:
Mailing address:
  • Phone: 772-569-4118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNA KATZ SCHWIBNER
Title or Position: OWNER
Credential: DMD
Phone: 772-569-4118