MEDICARE: YOUR DENTAL OFFICE CORP

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1629935515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR DENTAL OFFICE CORP

Provider Business Mailing Address
First Line	:	3796 NW 19TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-4122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3796 NW 19TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-4122
Country	:	US
Telephone Number	:	954-739-1430
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. GURMAN SAHI
Credential	:
Telephone Number	:	954-864-0006

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “YOUR DENTAL OFFICE CORP ” Practice Location

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