MEDICARE: BAYVIEW DENTISTRY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1124996863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYVIEW DENTISTRY PA

Provider Business Mailing Address
First Line	:	3015 BAYVIEW DR STE B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1710
Country	:	US
Telephone Number	:	561-947-5063
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 BAYVIEW DR STE B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1710
Country	:	US
Telephone Number	:	561-947-5063
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHNNY C MORAES
Credential	:
Telephone Number	:	954-658-4561

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	10/24/2025

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Directions to “BAYVIEW DENTISTRY PA ” Practice Location

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