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General NPI Number Information
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NPI Number | 1376348581
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Entity Type | Organization
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Legal Business Name | ADONIAS PEDIATRIC DENTISTRY LLC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 5600 BLUE LAGOON DR STE 12AND13
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City | MIAMI
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State | FL
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Zip | 33126-2369
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Country | US
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Telephone | 786-438-4744
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Fax |
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Provider Business Mailing Address
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Address Line | 5600 BLUE LAGOON DR STE 12AND13
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City | MIAMI
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State | FL
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Zip | 33126-2369
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Country | US
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Telephone | 786-438-4744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAULA EGHAREVBA
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Credential | DDS
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Telephone | 773-398-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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