Healthcare Provider Details

I. General information

NPI: 1912683624
Provider Name (Legal Business Name): DAVID ESCALANTE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID ESCALANTE DMD

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16340 S POST RD APT 303
WESTON FL
33331-3554
US

IV. Provider business mailing address

16340 S POST RD APT 303
WESTON FL
33331-3554
US

V. Phone/Fax

Practice location:
  • Phone: 754-465-3084
  • Fax:
Mailing address:
  • Phone: 754-465-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH28793
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: