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General NPI Number Information
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NPI Number | 1659951077
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Entity Type | Individual
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Provider Name | DR. CHEMIKA ST JUSTE PHANORD
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Gender | Female
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 1261 S FEDERAL HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7070
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Country | US
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Telephone | 954-942-4048
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Fax | 954-788-5264
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Provider Business Mailing Address
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Address Line | 2631 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4939
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN25859
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License Number State | FL
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