MEDICARE: AURORA DENTAL OF NORTH SHORE PLLC

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	:	1841164688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURORA DENTAL OF NORTH SHORE PLLC

Provider Business Mailing Address
First Line	:	4868 SW 72ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-5526
Country	:	US
Telephone Number	:	305-771-0874
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 NW 12TH AVE STE 4
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-2026
Country	:	US
Telephone Number	:	305-771-0874
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSE L YABER
Credential	:	DDS
Telephone Number	:	305-771-0874

Provider Enumeration Date	:	10/03/2025
Last Update Date	:	10/03/2025

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