MEDICARE: CORAL RIDGE SMILE

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	:	1689794505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORAL RIDGE SMILE

Provider Business Mailing Address
First Line	:	2324 NE 53RD ST.
Second Line	:
City	:	FT. LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-990-6543
Fax Number	:	954-941-4876

Provider Business Practice Location Address
First Line	:	2324 NE 53RD ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-3212
Country	:	US
Telephone Number	:	954-990-6543
Fax Number	:	954-491-4876

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MANDANA MIR ESMAILI
Credential	:	D.D.S.
Telephone Number	:	954-990-6543

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	02/16/2012

Similar Medicare Providers

1679656862 — DAVID B ROONEY MD
Practice Location Address:

2340 NE 53RD ST
FT LAUDERDALE, FL
33308-3212

Practice Phone: 954-776-7755
Practice Fax: 954-771-2722

1811194640 — GERIATRIC HEALTH SYSTEMS INC.
Practice Location Address:

2340 NE 53RD ST
FT LAUDERDALE, FL
33308-3212

Practice Phone: 954-776-7755
Practice Fax: 954-771-2722

1073704227 — ALDO MORALES MD PA
Practice Location Address:

2340 NE 53RD ST
FT LAUDERDALE, FL
33308-3212

Practice Phone: 954-771-5410
Practice Fax: 954-771-5695

1679703631 — KAMI LALJI, D.P.M.,P.A.
Practice Location Address:

2330 NE 53RD ST
FT. LAUDERDALE, FL
33308-3212

Practice Phone: 954-772-5380
Practice Fax:

1023394376 — MRS. ANGELA KAE HESSELBROCK LPC
Practice Location Address:

3212 COLLINSWORTH ST , SUITE 22
FT WORTH, TX
76107-6580

Practice Phone: 817-343-1553
Practice Fax:

1285620807 — DR. BRUCE HOLZ DDS
Practice Location Address:

2320 NE 53RD ST
FORT LAUDERDALE, FL
33308-3212

Practice Phone: 954-492-8126
Practice Fax: 954-771-7505

Directions to “CORAL RIDGE SMILE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.