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General NPI Number Information
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NPI Number | 1659896330
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Entity Type | Organization
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Legal Business Name | LITTLE STARS DENTISTRY OF MIAMI SHORES
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Dates
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Enumeration Date | 08/03/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 660 NE 95TH ST STE 9
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2758
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Country | US
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Telephone | 305-754-5081
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Fax |
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Provider Business Mailing Address
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Address Line | 660 NE 95TH ST STE 9
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2758
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Country | US
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Telephone | 305-754-5081
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | YANAY HERNANDEZ
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Credential |
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Telephone | 305-773-5316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN14474
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN13832
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License Number State | FL
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