=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124980909
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DKP FLORIDA DENTAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2025
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5979 VINELAND RD STE 315
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32819-7856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 689-217-6543
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5979 VINELAND RD STE 315
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32819-7856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 689-217-6543
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER/DOCTOR
-----------------------------------------------------
Name | MR. PEDRO HENRIQUE DA SILA ASCHAR
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 321-271-1644
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------