florida medicaid child - client liberty dental plan...prairie dental center 6320 sw 13th st...

Member Services / Servicios para miembros : (833) 276-0850

FLORIDA MEDICAID CHILD

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

ALACHUA COUNTY

DENTIST

#RHC010936

Acorn Clinic

23320 N. State Rd, Ste 235

Brooker, FL 32622

(352) 485-2772

Special Needs: Yes

Gujarati, English, Spanish

M-T 8am-4pm

W-Th 8am-4pm

# DN8024 Aguirre, Michael

NPI: 1740388800 LIC: DN8024

CERTIFICATIONS :

# DN18987 Bhakta, Paayal

NPI: 1033439823 LIC: DN18987

CERTIFICATIONS :

# DN9374 Hsiung, Edwin

NPI: 1417389586 LIC: DN9374

CERTIFICATIONS :

# DN21295 Luaces, Olga

NPI: 1407237555 LIC: DN21295

CERTIFICATIONS :

# DN6188 Witt, William

NPI: 1417987967 LIC: DN6188

CERTIFICATIONS :

#FQHC010440

Azalea Health

410 Ne Waldo Road

Gainesville, FL 32641

(352) 375-3790

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

# DN21424 Budzinski, Volha

NPI: 1588047468 LIC: DN21424

CERTIFICATIONS :

# DN15770 Halady, Pratima

NPI: 1720256811 LIC: DN15770

CERTIFICATIONS :

# HAD56 Krotzinger, Mary

NPI: 1992796973 LIC: HAD56

CERTIFICATIONS :

# DN20873 Lopez, Melvin

NPI: 1689081242 LIC: DN20873

CERTIFICATIONS :

# DN12941 Pairot, Alfredo

NPI: 1932174448 LIC: DN12941

CERTIFICATIONS :

# DN8746 Saraga, David

NPI: 1780805028 LIC: DN8746

CERTIFICATIONS :

#CHC014623

DOH - Alachua County Health

Department

816 Sw 64Th Terrance


(352) 334-8839

Special Needs: Yes

English, Russian, Bulgarian, German,

Italian, Spanish

W 8am-5pm,

# DN18987 Bhakta, Paayal

NPI: 1033439823 LIC: DN18987

CERTIFICATIONS :

# DN19484 Jones, Stephanie

NPI: 1548549678 LIC: DN19484

CERTIFICATIONS :

# DN21933 Vu, Clara

NPI: 1235589482 LIC: DN21933

CERTIFICATIONS :

• Inhalation Sedation

# DN18661 Whitford, Drew

NPI: 1851527303 LIC: DN18661

CERTIFICATIONS :


#CHC017031

DOH - Alachua County Health

Department

224 Se 24Th St


(352) 334-8839

Special Needs: Yes

English, Spanish

M-T 8am-5pm

Th-F 8am-5pm

# DN19484 Jones, Stephanie

NPI: 1548549678 LIC: DN19484

CERTIFICATIONS :

# DN21933 Vu, Clara

NPI: 1235589482 LIC: DN21933

CERTIFICATIONS :


# DN18661 Whitford, Drew

NPI: 1851527303 LIC: DN18661

CERTIFICATIONS :


#020933

Prairie Dental Center

6320 Sw 13Th St


(352) 373-3431

Special Needs: No

English, Farsi, Persian

M-T 8am-4pm

F 8am-2pm

# DN13800 Abolverdi, Shaun

NPI: 1669511598 LIC: DN13800

CERTIFICATIONS :

#010755

University of Florida College of

Dentistry

1600 Sw Archer Road


www.dental.ufl.edu

(352) 273-6820

Special Needs: Yes

English, Other

M-T 8am-5pm

W-F 8am-5pm

# DN14714 Barnes, David

NPI: 1467667451 LIC: DN14714

CERTIFICATIONS :

# DN7077 Benjamin, Paul

NPI: 1225057128 LIC: DN7077

CERTIFICATIONS :

# DTP675 Camargo, Carlos

NPI: 1518459312 LIC: DTP675

CERTIFICATIONS :

# DTP657 Cassiano, Luisa

NPI: 1295281335 LIC: DTP657

CERTIFICATIONS :

# DN8382 Cook, Larry

NPI: 1902813777 LIC: DN8382

CERTIFICATIONS :

# DTP630 Delgado Caraballo, Maria

NPI: 1003274002 LIC: DTP630

CERTIFICATIONS :

# DTP603 Delgado, Alejandro

NPI: 1669887485 LIC: DTP603

CERTIFICATIONS :

# DTP639 Dias Ribeiro, Ana

NPI: 1053860924 LIC: DTP639

CERTIFICATIONS :

# DN13471 Dilbone, Deborah

NPI: 1104882497 LIC: DN13471

CERTIFICATIONS :

# DN16318 Djuric, Amira

NPI: 1033291471 LIC: DN16318

CERTIFICATIONS :

# DN8807 Garvey, Timothy

NPI: 1205892296 LIC: DN8807

CERTIFICATIONS :

# DTP400 Gibbs, Micaela

NPI: 1902862469 LIC: DTP400

CERTIFICATIONS :

# DTP680 Guha, Upoma

NPI: 1184153132 LIC: DTP680

CERTIFICATIONS :

# DN7710 Haddix, James

NPI: 1336105709 LIC: DN7710

CERTIFICATIONS :

# DTP672 Haddock, Fernando

NPI: 1477531234 LIC: DTP672

CERTIFICATIONS :

# DTP679 Hansen, Matthew

NPI: 1598008153 LIC: DTP679

CERTIFICATIONS :

# DN9870 Kaleel, Nicholas

NPI: 1447258991 LIC: DN9870

CERTIFICATIONS :

# DTP604 Kashtwari, Deeba

NPI: 1669880407 LIC: DTP604

CERTIFICATIONS :

# DN21295 Luaces, Olga

NPI: 1407237555 LIC: DN21295

CERTIFICATIONS :

# DTP659 Migliorati, Cesar

NPI: 1992810519 LIC: DTP659

CERTIFICATIONS :

LIBERTY Dental Plan network provider rating is based on quality measures and service.

Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice.

Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan.

If you need to access LIBERTY’s free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, www.libertydentalplan.com/FLMedicaid.

El directorio de proveedores está sujeto a cambios sin previo aviso.

Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan.

Si necesita usar los servicios gratuitos de interpretación de LIBERTY, llame al número que aparece en su tarjeta de identificación.

Para ver los proveedores actuales, visite nuestro sitio web, www.libertydentalplan.com/FLMedicaid.

* Closed to new members / Cerrado para nuevos miembros. Page 1 of 295

June, 2020

06/15/2020 v.1(2018)

Wheelchair access / Acceso para personas en silla de ruedas.





# DTP497 Nascimento, Marcelle

NPI: 1275706426 LIC: DTP497

CERTIFICATIONS :

# DTP702 Oliveira, Dayane

NPI: 1487204178 LIC: DTP702

CERTIFICATIONS :

# DN8944 Ottenga, Marc

NPI: 1306802293 LIC: DN8944

CERTIFICATIONS :


# DTP612 Pereira, Patricia

NPI: 1437535218 LIC: DTP612

CERTIFICATIONS :

# DTP683 Reis, Andre

NPI: 1891278768 LIC: DTP683

CERTIFICATIONS :

# DN14930 Rey, Rosalia

NPI: 1346341443 LIC: DN14930

CERTIFICATIONS :

# DTP490 Ribeiro-DaSilva, Margarete

NPI: 1326228321 LIC: DTP490

CERTIFICATIONS :

# DTP562 Roulet, Jean-Francois

NPI: 1831539816 LIC: DTP562

CERTIFICATIONS :

# DTP623 Ruprecht, Axel

NPI: 1699763631 LIC: DTP623

CERTIFICATIONS :

# DTP669 Sikand, Rebecca

NPI: 1942654546 LIC: DTP669

CERTIFICATIONS :

# DTP645 Silva, Maria

NPI: 1932452547 LIC: DTP645

CERTIFICATIONS :

# DTP652 Soto, Annetty

NPI: 1780024315 LIC: DTP652

CERTIFICATIONS :

# DTP458 Tomar, Scott

NPI: 1487606950 LIC: DTP458

CERTIFICATIONS :

ENDODONTICS

#022671

North Central Florida Endodontics

1905 Nw 13Th Street, Ste 2


(352) 375-7776

Special Needs: No

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

# DN5901 Goldfaden, Stephen

NPI: 1417014457 LIC: DN5901

CERTIFICATIONS :


# DN23014 Natera-Fernandez,

Marianella

NPI: 1073061297 LIC: DN23014

CERTIFICATIONS :

#010755


Dentistry

1600 Sw Archer Road


www.dental.ufl.edu

(352) 273-6820

Special Needs: Yes

English, Other

M-T 8am-5pm

W-F 8am-5pm

# DTP654 Bakiri, Eleonora

NPI: 1952834418 LIC: DTP654

CERTIFICATIONS :

# DTP700 Marchesan, Melissa

NPI: 1427359678 LIC: DTP700

CERTIFICATIONS :

# DTP450 Pileggi, Roberta

NPI: 1356393821 LIC: DTP450

CERTIFICATIONS :

• Board Certification


# DTP701 Vieira Ozorio, Jose

NPI: 1588111710 LIC: DTP701

CERTIFICATIONS :

ORAL SURGEON

# DN9991 Bowers, Thomas

NPI: 1851340426 LIC: DN9991

CERTIFICATIONS :

• General Anesthesia


# DTP232 Dolwick, Melvin

NPI: 1659337590 LIC: DTP232

CERTIFICATIONS :



# DTP664 Freburg-Hoffmeister,

Danielle

NPI: 1447545132 LIC: DTP664

CERTIFICATIONS :


# DTP709 Gohel, Anita

NPI: 1841563947 LIC: DTP709

CERTIFICATIONS :

# DN19786 Hamrick, Clayton

NPI: 1548523665 LIC: DN19786

CERTIFICATIONS :

# DN12910 Hardeman, John

NPI: 1447343918 LIC: DN12910

CERTIFICATIONS :




ORTHODONTIST

#010955

Joseph M Waldron, DDS

611 Nw 60Th Street, Ste A


(352) 331-5622

Special Needs: No

English

M-T 8am-5pm

W-F 8am-5pm

# DN6502 Waldron, Joseph

NPI: 1063623635 LIC: DN6502

CERTIFICATIONS :

#010755


Dentistry

1600 Sw Archer Road


www.dental.ufl.edu

(352) 273-6820

Special Needs: Yes

English, Other

M-T 8am-5pm

W-F 8am-5pm

# DN13393 Dolce, Calogero

NPI: 1881650331 LIC: DN13393

CERTIFICATIONS :


# DN15392 Donatelli, Richard

NPI: 1942387535 LIC: DN15392

CERTIFICATIONS :

# DT394 Neubert, John

NPI: 1760448989 LIC: DT394

CERTIFICATIONS :

PEDIATRIC DENTISTRY

#RHC010936

Acorn Clinic

23320 N. State Rd, Ste 235

Brooker, FL 32622

(352) 485-2772

Special Needs: Yes

Gujarati, English, Spanish

M-T 8am-4pm

W-Th 8am-4pm

# DTP267 Jerrell, Roy

NPI: 1932159803 LIC: DTP267

CERTIFICATIONS :

# DTP568 Mugayar, Leda

NPI: 1043585706 LIC: DTP568

CERTIFICATIONS :


# DN18234 Perez, Edna

NPI: 1962536714 LIC: DN18234

CERTIFICATIONS :



#011100

Millhopper Pediatric Dentistry, PL

2341 Nw 41St Street, Ste A


(352) 336-3939

Special Needs: Yes

English, Spanish

M-T 8am-4pm

W-Th 8am-4pm

# DN15273 Beaufait, Nguyet

NPI: 1457380719 LIC: DN15273












June, 2020

06/15/2020 v.1(2018)





CERTIFICATIONS :



• Pediatric Conscious Sedation

#010755


Dentistry

1600 Sw Archer Road


www.dental.ufl.edu

(352) 273-6820

Special Needs: Yes

English, Other

M-T 8am-5pm

W-F 8am-5pm

# DTP437 Adewumi, Abimbola*

NPI: 1285690636 LIC: DTP437

CERTIFICATIONS :



# DN22995 Connell, Christopher*

NPI: 1689125742 LIC: DN22995

CERTIFICATIONS :


# DTP418 Guelmann, Marcio*

NPI: 1972568848 LIC: DTP418

CERTIFICATIONS :



# DTP267 Jerrell, Roy*

NPI: 1932159803 LIC: DTP267

CERTIFICATIONS :

# DN20915 Moore, Ronda*

NPI: 1033474176 LIC: DN20915

CERTIFICATIONS :

# DTP568 Mugayar, Leda*

NPI: 1043585706 LIC: DTP568

CERTIFICATIONS :


# DN18234 Perez, Edna*

NPI: 1962536714 LIC: DN18234

CERTIFICATIONS :



PERIODONTICS

# DTP606 Chang, Jia

NPI: 1871862029 LIC: DTP606

CERTIFICATIONS :

# DTP687 Duarte Reis, Poliana

NPI: 1619448677 LIC: DTP687

CERTIFICATIONS :

# DTP638 Duarte, Wagner

NPI: 1407305022 LIC: DTP638

CERTIFICATIONS :

# DTP537 Neiva, Rodrigo

NPI: 1457485229 LIC: DTP537

CERTIFICATIONS :

# DN21876 Schey, Karin

NPI: 1285086173 LIC: DN21876

CERTIFICATIONS :

# DTP690 Tanaka, Tsuyoshi

NPI: 1407208853 LIC: DTP690

CERTIFICATIONS :

PROSTHODONTICS

# DTP390 Echeto, Luisa

NPI: 1144286386 LIC: DTP390

CERTIFICATIONS :

# DTP467 Esquivel-Upshaw,

Josephine

NPI: 1760495527 LIC: DTP467

CERTIFICATIONS :

# DTP439 O'Neill, Edgar

NPI: 1235195413 LIC: DTP439

CERTIFICATIONS :

BAKER COUNTY

DENTIST

#CHC013141

DOH - Baker County Health

Department

480 W. Lowder St

Macclenny, FL 32063

[email protected]

(904) 259-9815

Special Needs: Yes

M-T 8am-5pm

W-Th 8am-5pm

# DN11888 Hackney, Tara

NPI: 1710953765 LIC: DN11888

CERTIFICATIONS :


# DN18785 Patel, Viral

NPI: 1881917540 LIC: DN18785

CERTIFICATIONS :


# DN11385 Traul Jr., Robert

NPI: 1982734257 LIC: DN11385

CERTIFICATIONS :

BAY COUNTY

DENTIST

#CHC10280

DOH - Bay County Health

Department

3518 E. 15Th St

Panama City, FL 32404

(850) 872-4455

Special Needs: Yes

English, Spanish

M-T 7am-4pm

W-F 7am-4pm

# DN21103 Ghani, Rehan

NPI: 1316333230 LIC: DN21103

CERTIFICATIONS :


# DN18413 Morshed, Aly

NPI: 1730244948 LIC: DN18413

CERTIFICATIONS :


#010672

Eric R. Claussen D.M.D., P.A.

2624 Jenks Ave


(850) 215-0798

Special Needs: Yes

English

M-T 8am-5pm

W-F 8am-5pm

# DN17200 Fleigel III, Jeffrey*

NPI: 1336357748 LIC: DN17200

CERTIFICATIONS :


#FQHC022012

PanCare of Florida

12427 Hwy 231

Youngstown, FL 32466

(850) 215-3575

Special Needs: Yes

English

M-T 8am-5pm

W-F 8am-5pm

# DN19128 Claussen, Meghann

NPI: 1336454651 LIC: DN19128

CERTIFICATIONS :

# DN13094 Hudon, Richard

NPI: 1245336031 LIC: DN13094

CERTIFICATIONS :

# DN23419 Lindsay, Sean

NPI: 1477046290 LIC: DN23419

CERTIFICATIONS :

# DN21740 Moffa, Michelle

NPI: 1841277407 LIC: DN21740

CERTIFICATIONS :

# DN19745 Norton, Andrew

NPI: 1861754020 LIC: DN19745

CERTIFICATIONS :

# DN18871 Pate, Sheena

NPI: 1215255880 LIC: DN18871

CERTIFICATIONS :

# DN21660 Piorkowski, Gary

NPI: 1699705434 LIC: DN21660

CERTIFICATIONS :

# HAD69 Smith, Amy

NPI: 1831209899 LIC: HAD69

CERTIFICATIONS :

# DN18668 Van Dyke, Kanyaratana

NPI: 1003122656 LIC: DN18668

CERTIFICATIONS :

# DN22573 Williams, Sean

NPI: 1306376512 LIC: DN22573

CERTIFICATIONS :

#FQHC010683

PanCare of Florida, Inc.

403 E. 11Th St


(850) 767-3350

Special Needs: Yes

English, Spanish

M-T 8am-5pm












June, 2020

06/15/2020 v.1(2018)





W-F 8am-5pm

S 8am - 5pm

# DN19128 Claussen, Meghann

NPI: 1336454651 LIC: DN19128

CERTIFICATIONS :

# DN13094 Hudon, Richard

NPI: 1245336031 LIC: DN13094

CERTIFICATIONS :

# DN23419 Lindsay, Sean

NPI: 1477046290 LIC: DN23419

CERTIFICATIONS :

# DN21740 Moffa, Michelle

NPI: 1841277407 LIC: DN21740

CERTIFICATIONS :

# DN19745 Norton, Andrew

NPI: 1861754020 LIC: DN19745

CERTIFICATIONS :

# DN18871 Pate, Sheena

NPI: 1215255880 LIC: DN18871

CERTIFICATIONS :

# DN21660 Piorkowski, Gary

NPI: 1699705434 LIC: DN21660

CERTIFICATIONS :

# DN23084 Santos, Iris

NPI: 1487875233 LIC: DN23084

CERTIFICATIONS :

# HAD69 Smith, Amy

NPI: 1831209899 LIC: HAD69

CERTIFICATIONS :

# DN18668 Van Dyke, Kanyaratana

NPI: 1003122656 LIC: DN18668

CERTIFICATIONS :

# DN22573 Williams, Sean

NPI: 1306376512 LIC: DN22573

CERTIFICATIONS :

#014966

Royal Dental

2335 State Ave Ste A


www.royaldentalpanamacity.com

(850) 740-3100

Special Needs: Yes

English, Arabic

M-T 8am-5pm

W-Th 8am-5pm

S 8am - 1pm

# DN21597 Abdulrahim, Yahia

NPI: 1184092603 LIC: DN21597

CERTIFICATIONS :

ENDODONTICS

#018484

Hanson Endodontics

2999 W 10Th St


www.hansonendo.com

(850) 215-3339

Special Needs: Yes

English

M-T 8am-4pm

W 8am-4pm,

# DN17872 Hanson, Shane

NPI: 1710907787 LIC: DN17872

CERTIFICATIONS :


#FQHC022012

PanCare of Florida

12427 Hwy 231

Youngstown, FL 32466

(850) 215-3575

Special Needs: Yes

English

M-T 8am-5pm

W-F 8am-5pm

# HAD73 Pankuch, Richard

NPI: 1467452847 LIC: HAD73

CERTIFICATIONS :

# HAD65 Wilhite, Rhonda

NPI: 1952496341 LIC: HAD65

CERTIFICATIONS :

#FQHC010683

PanCare of Florida, Inc.

403 E. 11Th St


(850) 767-3350

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 8am - 5pm

# HAD73 Pankuch, Richard

NPI: 1467452847 LIC: HAD73

CERTIFICATIONS :

# HAD65 Wilhite, Rhonda

NPI: 1952496341 LIC: HAD65

CERTIFICATIONS :

ORAL SURGEON

#010672

Eric R. Claussen D.M.D., P.A.

2624 Jenks Ave


(850) 215-0798

Special Needs: Yes

English

M-T 8am-5pm

W-F 8am-5pm

# DN17080 Claussen, Eric

NPI: 1194983965 LIC: DN17080

CERTIFICATIONS :



# DN23806 Long, Larry

NPI: 1275527137 LIC: DN23806

CERTIFICATIONS :

ORTHODONTIST

#011426

Advanced Orthodontics

2202 State Ave, Ste 200


(850) 296-8665

Special Needs: Yes

English

M 9am - 6pm, T 8am - 5pm

W-Th 8am-5pm

# DN19214 Kovaleski, Lauren

NPI: 1366754558 LIC: DN19214

CERTIFICATIONS :

# DN10667 Wheeler, Timothy

NPI: 1558328153 LIC: DN10667

CERTIFICATIONS :


BREVARD COUNTY

DENTIST

#FQHC011681

Brevard Health Alliance

2120 Sarno Rd

Melbourne, FL 32935

(321) 241-6800

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

# HAD82 Alongi, Jennifer

NPI: 1306139019 LIC: HAD82

CERTIFICATIONS :


# DN14021 Cheshire, Gregory

NPI: 1952303059 LIC: DN14021

CERTIFICATIONS :


# DN21925 Eley, Joel

NPI: 1326491093 LIC: DN21925

CERTIFICATIONS :


# DN9369 Estes, Philip

NPI: 1255766937 LIC: DN9369

CERTIFICATIONS :


# DN13760 Hachmeister, Kevin

NPI: 1811922966 LIC: DN13760

CERTIFICATIONS :

# DN20658 Smith, Ross

NPI: 1245626811 LIC: DN20658

CERTIFICATIONS :


#FQHC011682


220 Barton Blvd, Unit C14

Rockledge, FL 32955

(321) 639-5177

Special Needs: Yes

English, Spanish

M-T 8am-7pm

W-Th 8am-7pm

# HAD82 Alongi, Jennifer*

NPI: 1306139019 LIC: HAD82

CERTIFICATIONS :













June, 2020

06/15/2020 v.1(2018)





# DN14021 Cheshire, Gregory*

NPI: 1952303059 LIC: DN14021

CERTIFICATIONS :


# DN21925 Eley, Joel*

NPI: 1326491093 LIC: DN21925

CERTIFICATIONS :


# DN9369 Estes, Philip*

NPI: 1255766937 LIC: DN9369

CERTIFICATIONS :


# DN13760 Hachmeister, Kevin*

NPI: 1811922966 LIC: DN13760

CERTIFICATIONS :

# DN20658 Smith, Ross*

NPI: 1245626811 LIC: DN20658

CERTIFICATIONS :


#FQHC016241


7227 N. Us Hwy 1

Cocoa, FL 32927

(321) 877-2740

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

# HAD82 Alongi, Jennifer

NPI: 1306139019 LIC: HAD82

CERTIFICATIONS :


# DN14021 Cheshire, Gregory

NPI: 1952303059 LIC: DN14021

CERTIFICATIONS :


# DN21925 Eley, Joel

NPI: 1326491093 LIC: DN21925

CERTIFICATIONS :


# DN9369 Estes, Philip

NPI: 1255766937 LIC: DN9369

CERTIFICATIONS :


# DN13760 Hachmeister, Kevin

NPI: 1811922966 LIC: DN13760

CERTIFICATIONS :

# DN20658 Smith, Ross

NPI: 1245626811 LIC: DN20658

CERTIFICATIONS :


#011378

Diane P Jones, DMD, PA

4670 Lipscomb Street Ne, Ste 13

Palm Bay, FL 32905

(321) 724-1343

Special Needs: No

English, Spanish

M-T 8am-5pm

W-Th 8am-5pm

# DN10077 Jones, Diane

NPI: 1699893651 LIC: DN10077

CERTIFICATIONS :

#CHC015259

DOH - Brevard County Health

Department

2555 Judge Fran Jamieson Way

Viera, FL 32940

(321) 639-5801

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W 8am-5pm,

# DN9634 Humphrey, Willie

NPI: 1225190184 LIC: DN9634

CERTIFICATIONS :

# DN17682 Klair, Kelly

NPI: 1205033222 LIC: DN17682

CERTIFICATIONS :

# DN21014 Nagaraju, Champaka

NPI: 1659769891 LIC: DN21014

CERTIFICATIONS :


NPI: 1982734257 LIC: DN11385

CERTIFICATIONS :

#CHC015260


Department

611 N. Singleton Ave

Titusville, FL 32796

(321) 637-7300

Special Needs: Yes

English, Spanish

W-Th 8am-5pm

# DN9634 Humphrey, Willie

NPI: 1225190184 LIC: DN9634

CERTIFICATIONS :

# DN17682 Klair, Kelly

NPI: 1205033222 LIC: DN17682

CERTIFICATIONS :

# DN21014 Nagaraju, Champaka

NPI: 1659769891 LIC: DN21014

CERTIFICATIONS :


NPI: 1982734257 LIC: DN11385

CERTIFICATIONS :

#012071

Magic Dental Care

6050 Babcock St Se, Ste #2

Palm Bay, FL 32909

(321) 725-9946

Special Needs: Yes

English, Arabic, Creoles and Pidgins

French-based(other), French, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 9am - 3pm

# DN15094 Assaf, Wasim

NPI: 1518048065 LIC: DN15094

CERTIFICATIONS :


# DN21380 Taha, Ahmed

NPI: 1225411069 LIC: DN21380

CERTIFICATIONS :


# DN21065 Vinokur, Stephanie

NPI: 1356733000 LIC: DN21065

CERTIFICATIONS :


#022011

Magic Dental Care II

1325 Pine Street, Ste 103

Melbourne, FL 32901

(321) 724-4520

Special Needs: No

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 9am - 4pm

# DN15094 Assaf, Wasim

NPI: 1518048065 LIC: DN15094

CERTIFICATIONS :


# DN18934 Leder, Katia

NPI: 1578669552 LIC: DN18934

CERTIFICATIONS :


# DN21380 Taha, Ahmed

NPI: 1225411069 LIC: DN21380

CERTIFICATIONS :


# DN21065 Vinokur, Stephanie

NPI: 1356733000 LIC: DN21065

CERTIFICATIONS :


#022718

Quality Dentures, LLC

313 N. Babcock Street

Melbourne, FL 32935

(321) 259-1949

Special Needs: No

English

T 8am - 4pm

W-Th 8am-4pm

# DN10444 Bell, E. Scott

NPI: 1093725558 LIC: DN10444

CERTIFICATIONS :

ORAL SURGEON

#016288

Great Expressions Dental Centers

205 Palm Bay Road, Ste 159

Melbourne, FL 32904

(321) 676-4080

Special Needs: Yes

English, Russian, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 9am - 2pm

# DN22442 Turner, Mark

NPI: 1003252685 LIC: DN22442

CERTIFICATIONS :












June, 2020

06/15/2020 v.1(2018)






PEDIATRIC DENTISTRY

#013507

Brevard Pediatric Dental

Associates - Merritt Island

2405 N Courtenay Pkwy Ste 105

Merritt Island, FL 32953

(321) 453-2450

Special Needs: Yes

English

M-T 8am-4pm

W-Th 8am-4pm

# DN11127 Milo, Scott

NPI: 1861668311 LIC: DN11127

CERTIFICATIONS :

• Conscious Sedation


#CHC015259


Department

2555 Judge Fran Jamieson Way

Viera, FL 32940

(321) 639-5801

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W 8am-5pm,

# HAD31 Cunnion, Dara

NPI: 1427128727 LIC: HAD31

CERTIFICATIONS :


#CHC015260


Department

611 N. Singleton Ave

Titusville, FL 32796

(321) 637-7300

Special Needs: Yes

English, Spanish

W-Th 8am-5pm

# HAD31 Cunnion, Dara

NPI: 1427128727 LIC: HAD31

CERTIFICATIONS :


#016288


205 Palm Bay Road, Ste 159

Melbourne, FL 32904

(321) 676-4080

Special Needs: Yes


M-T 8am-5pm

W-F 8am-5pm

S 9am - 2pm

# DN20688 Acheampong, Emmanuel

NPI: 1407122252 LIC: DN20688

CERTIFICATIONS :


#012071

Magic Dental Care

6050 Babcock St Se, Ste #2

Palm Bay, FL 32909

(321) 725-9946

Special Needs: Yes

English, Arabic, Creoles and Pidgins

French-based(other), French, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 9am - 3pm

# DN12799 Suarez, Maria

NPI: 1922015718 LIC: DN12799

CERTIFICATIONS :



# DN7046 Werner, Paul

NPI: 1053325852 LIC: DN7046

CERTIFICATIONS :



# DN17725 Wilson, Cindy

NPI: 1023196797 LIC: DN17725

CERTIFICATIONS :



#022011

Magic Dental Care II

1325 Pine Street, Ste 103

Melbourne, FL 32901

(321) 724-4520

Special Needs: No

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 9am - 4pm

# DN12799 Suarez, Maria

NPI: 1922015718 LIC: DN12799

CERTIFICATIONS :



# DN7046 Werner, Paul

NPI: 1053325852 LIC: DN7046

CERTIFICATIONS :



BROWARD COUNTY

DENTIST

#009564

A Healthy Smile Dental

12333 Nw 18Th St. Ste 2

Pembroke Pines, FL 33026

www.ahealthysmileforlife.com

(954) 885-4224

Special Needs: No

English, Spanish

M-T 9am-5pm

W-F 9am-5pm

# DN17340 Delgado, Ligming

NPI: 1548396658 LIC: DN17340

CERTIFICATIONS :

#008934

Ahmad Ahmadi D.M.D., PA

12311 Taft Street Ste 2


www.pearlywhitesmiles.fl.com

(954) 430-5700

Special Needs: Yes

English, Spanish, Persian

T 8am - 2pm

S 8am - 2pm

# DN16261 Ahmadi, Ahmad

NPI: 1538275292 LIC: DN16261

CERTIFICATIONS :

#008935

Ahmad Ahmadi D.M.D., PA

6656 Parkside Drive

Parkland, FL 33067

www.pearlywhitesmiles.fl.com

(954) 752-8283

Special Needs: Yes


M 8am - 2pm,

W 8am-2pm,

S 8am - 2pm

# DN16261 Ahmadi, Ahmad

NPI: 1538275292 LIC: DN16261

CERTIFICATIONS :

#013157

All Care Dental

3207 North State Road 7, Ste 24

Margate, FL 33063

(954) 979-1357

Special Needs: Yes

English, Spanish, Portuguese


W 9am-5pm, Th 9am-7pm,F

10am-12pm

# DN16620 Yeoshoua, Oded

NPI: 1396969507 LIC: DN16620

CERTIFICATIONS :

#022277

Allure Dental of Plantation PLLC

1945 N Pine Island Road

Fort Lauderdale, FL 33322

(954) 473-9161

Special Needs: Yes


M-T 9am-5pm

W-F 9am-5pm

S 9am - 2pm

# DN20596 Coyle, Sean

NPI: 1962814632 LIC: DN20596

CERTIFICATIONS :

# DN20696 Kopynets, Viktor

NPI: 1932517042 LIC: DN20696

CERTIFICATIONS :


# DN12167 Kuntsmann, Vivian












June, 2020

06/15/2020 v.1(2018)





NPI: 1104995539 LIC: DN12167

CERTIFICATIONS :

# DN24073 Martinez, Lester

NPI: 1689235624 LIC: DN24073

CERTIFICATIONS :

# DN17761 Valdman, Vadim

NPI: 1184860413 LIC: DN17761

CERTIFICATIONS :


#016880

Allure Dental PLLC

4267 W. Commerical Blvd

Tamarac, FL 33319

(954) 677-3202

Special Needs: Yes

English, Russian, French, Spanish

M-T 9am-5pm

Th-F 9am-5pm

S 9am - 3pm

# DN20596 Coyle, Sean

NPI: 1962814632 LIC: DN20596

CERTIFICATIONS :

# DN20696 Kopynets, Viktor

NPI: 1932517042 LIC: DN20696

CERTIFICATIONS :


# DN24073 Martinez, Lester

NPI: 1689235624 LIC: DN24073

CERTIFICATIONS :

# DN17761 Valdman, Vadim

NPI: 1184860413 LIC: DN17761

CERTIFICATIONS :


#020859

American Dental of Florida Ft

Lauderdale

2740 E. Commercial Blvd


(954) 938-2447

Special Needs: Yes

English, Spanish

M-T 8am-6pm

W-F 8am-6pm

# DN22874 Gutierrez, Helem

NPI: 1679095905 LIC: DN22874

CERTIFICATIONS :


#020858

American Dental of Florida

Margate

1605 North State Road 7 #C

Margate, FL 33063

www.smiledesigndentalfl.com

(954) 974-8550

Special Needs: Yes

English, Spanish

W 10am-6pm,

# DN22874 Gutierrez, Helem

NPI: 1679095905 LIC: DN22874

CERTIFICATIONS :


#011659

American Pediatric Dental Group

10021 Pines Blvd Ste 100


(954) 417-1337

Special Needs: Yes

English


W 8am-5pm, Th 9am-5pm,F 8am-5pm

S 8am - 2pm

# DN18955 Agrawal, Ankur

NPI: 1659697415 LIC: DN18955

CERTIFICATIONS :


# DN19603 Frand, Joel

NPI: 1568675866 LIC: DN19603

CERTIFICATIONS :


# DN21518 Mejia Valencia, Ana

NPI: 1073942629 LIC: DN21518

CERTIFICATIONS :


# DN20294 Slement, Gaby

NPI: 1003244179 LIC: DN20294

CERTIFICATIONS :


# DN21826 Vegas, Gabriela

NPI: 1407273881 LIC: DN21826

CERTIFICATIONS :


# DN22896 Yazaji, Roula

NPI: 1669995684 LIC: DN22896

CERTIFICATIONS :


#013938


Coral Springs

3353 N. University Drive

Coral Springs, FL 33065

(954) 416-0727

Special Needs: Yes

English



S 8am - 1pm


NPI: 1659697415 LIC: DN18955

CERTIFICATIONS :



NPI: 1568675866 LIC: DN19603

CERTIFICATIONS :



NPI: 1073942629 LIC: DN21518

CERTIFICATIONS :



NPI: 1003244179 LIC: DN20294

CERTIFICATIONS :



NPI: 1407273881 LIC: DN21826

CERTIFICATIONS :



NPI: 1669995684 LIC: DN22896

CERTIFICATIONS :


#017959


Plantation

12331 Sw 3Rd St, Ste 500

Plantation, FL 33325

(954) 417-1331

Special Needs: Yes

English



S 8am - 1pm


NPI: 1659697415 LIC: DN18955

CERTIFICATIONS :



NPI: 1568675866 LIC: DN19603

CERTIFICATIONS :



NPI: 1073942629 LIC: DN21518

CERTIFICATIONS :



NPI: 1003244179 LIC: DN20294

CERTIFICATIONS :



NPI: 1407273881 LIC: DN21826

CERTIFICATIONS :



NPI: 1669995684 LIC: DN22896

CERTIFICATIONS :


#008282

Andrew Dental Care Center, PA

3909 N. Andrews Ave

Oakland Park, FL 33309

(954) 561-6675

Special Needs: Yes

English, Spanish, Haitian; Haitian

Creole

T 9am - 5pm


S 9am - 5pm

# DN17611 Riley, Marilyn

NPI: 1114941614 LIC: DN17611

CERTIFICATIONS :

#016082

Angelic Smiles Dental Spa

9990 Nw 6Th Court












June, 2020

06/15/2020 v.1(2018)





Hollywood, FL 33024

www.angelicsmilesdentalspa.com

(954) 237-3902

Special Needs: No

English, Spanish

M 9am - 6pm,

Th-F 9am-4pm

S 9am - 2pm

# DN19661 Williams, Tosha

NPI: 1609009463 LIC: DN19661

CERTIFICATIONS :


#010213

Bella Family Dental, Inc.

19551 Sheridan Street


www.mybellafamilydental,com

(954) 621-7959

Special Needs: Yes

English, Spanish

M-T 9am-5pm

W-F 9am-5pm

# DN19939 Ruiz Frontany, Yarimar

NPI: 1134429251 LIC: DN19939

CERTIFICATIONS :


#020606

Bright Smiles of Sunrise

10108 W Oakland Park Blvd.

Sunrise, FL 33351

(954) 900-2059

Special Needs: No

English, Spanish



# DN21846 Fonseca, Jacqueline

NPI: 1487005369 LIC: DN21846

CERTIFICATIONS :

#FQHC020446

Broward Community & Family

Health Centers, Inc

162 N. Powerline Rd.

Pompano Beach, FL 33069

www.bcfhc.org

(954) 970-7067

Special Needs: Yes

English, Spanish, Creoles and Pidgins

(other), French


W-F 8am-5pm

S 8am - 1pm

# DN23003 Aldorri, Khalid

NPI: 1396261277 LIC: DN23003

CERTIFICATIONS :

# DN24341 Salas, Julio

NPI: 1427619253 LIC: DN24341

CERTIFICATIONS :

# DN22291 Taylor, Shelly

NPI: 1508224155 LIC: DN22291

CERTIFICATIONS :

#006578

Broward Mall Dental

8000 W. Broward Blvd, Ste 1123


(954) 476-0802

Special Needs: Yes

Russian, Spanish

M-T 10am-9pm

W-F 10am-9pm

S-Su 10am-6pm

# DN22246 Antezana, Mauricio

NPI: 1063876399 LIC: DN22246

CERTIFICATIONS :

# DN21079 Arnedo, Johanna

NPI: 1104213909 LIC: DN21079

CERTIFICATIONS :


# DN17412 Atkinson, William

NPI: 1942360862 LIC: DN17412

CERTIFICATIONS :


# DN21645 Baez Henry, Carlianette

NPI: 1235594961 LIC: DN21645

CERTIFICATIONS :

# DN17123 Bravo, Raquel

NPI: 1538312525 LIC: DN17123

CERTIFICATIONS :

# DN21812 Cabrera, Rene

NPI: 1518313675 LIC: DN21812

CERTIFICATIONS :

# DN7894 Cullen, William

NPI: 1013110535 LIC: DN7894

CERTIFICATIONS :


# DN21629 Durve, Aparna

NPI: 1437521580 LIC: DN21629

CERTIFICATIONS :

# DN22714 Fornes-Ferrero, Patricia

NPI: 1619407566 LIC: DN22714

CERTIFICATIONS :

# DN20945 Fornos, Jorge

NPI: 1831594415 LIC: DN20945

CERTIFICATIONS :

# DN22796 Gandhi, Poorvi

NPI: 1548631229 LIC: DN22796

CERTIFICATIONS :

# DN24375 Gaton Molina, Sarah

NPI: 1538713979 LIC: DN24375

CERTIFICATIONS :

# DN20710 Gonzalez, Kely

NPI: 1952717027 LIC: DN20710

CERTIFICATIONS :

# DN20151 Gonzalez, Kenia

NPI: 1578902813 LIC: DN20151

CERTIFICATIONS :

# DN10511 Green, George

NPI: 1609094580 LIC: DN10511

CERTIFICATIONS :

# DN22451 Gruenberg, Alex

NPI: 1255844924 LIC: DN22451

CERTIFICATIONS :

# DN22242 Guerra, Vannette

NPI: 1598184327 LIC: DN22242

CERTIFICATIONS :

# DN23847 Khan, Adiba

NPI: 1649638172 LIC: DN23847

CERTIFICATIONS :

# DN16377 Krasnov, Rostislav

NPI: 1942267935 LIC: DN16377

CERTIFICATIONS :

# DN24131 Krupnov, Vera

NPI: 1386202984 LIC: DN24131

CERTIFICATIONS :

# DN20101 Licina, Zeljka

NPI: 1013263292 LIC: DN20101

CERTIFICATIONS :

# DN23637 Lopez, Catherine

NPI: 1558841890 LIC: DN23637

CERTIFICATIONS :

# DN15694 Luong, Timothy

NPI: 1740302629 LIC: DN15694

CERTIFICATIONS :

# DN19470 Maniglia, Marielba

NPI: 1063793644 LIC: DN19470

CERTIFICATIONS :

# DN23402 Montenegro, Christian

NPI: 1144714445 LIC: DN23402

CERTIFICATIONS :

# DN23652 Ospina, Luz

NPI: 1881181501 LIC: DN23652

CERTIFICATIONS :

# DN22018 Pansuriya, Dharmendra

NPI: 1932645736 LIC: DN22018

CERTIFICATIONS :

# DN22702 Pham, Quynhnhu

NPI: 1609323948 LIC: DN22702

CERTIFICATIONS :

# DN21224 Ribot, Aliana

NPI: 1811377732 LIC: DN21224

CERTIFICATIONS :

# DN23021 Riboul, Sandrine

NPI: 1609227057 LIC: DN23021

CERTIFICATIONS :


# DN23007 Rivera, Lina

NPI: 1760908743 LIC: DN23007

CERTIFICATIONS :

# DN23099 Rodriguez, Iveliss

NPI: 1962971200 LIC: DN23099

CERTIFICATIONS :

# DN20475 Santiago, Germaine

NPI: 1922341460 LIC: DN20475

CERTIFICATIONS :

# DN23257 Shippee, Rebecca

NPI: 1841778164 LIC: DN23257

CERTIFICATIONS :

# DN18770 Trujillo, Madelene

NPI: 1881835767 LIC: DN18770

CERTIFICATIONS :

# DN21066 Uzunova-Dimova, Kalina

NPI: 1245540947 LIC: DN21066

CERTIFICATIONS :

#FQHC014907

Community AIDS Resource, Inc.












June, 2020

06/15/2020 v.1(2018)





871 W. Oakland Park Blvd


(954) 567-7141

Special Needs: Yes


French-based(other)

M-T 8am-5pm

Th-F 8am-5pm

# DN13731 Barnes, Curtis

NPI: 1689798936 LIC: DN13731

CERTIFICATIONS :

# DN18139 Casas, Manuel

NPI: 1740420090 LIC: DN18139

CERTIFICATIONS :

# DN20973 Martinez, Amy

NPI: 1124382866 LIC: DN20973

CERTIFICATIONS :

# DN20674 Sardinas, Yoan

NPI: 1992118657 LIC: DN20674

CERTIFICATIONS :

#009929

Coral Springs Family Dentistry

6267 West Sample Road


www.familydentistryofsouthflorida.c

om

(954) 341-4766

Special Needs: No


M-T 10am-7pm

W-F 10am-7pm

# DN14972 Stein, Ilya

NPI: 1235260407 LIC: DN14972

CERTIFICATIONS :

#021831

Coral Springs Family

Orthodontics

1881 N University Drive, Ste 208


(954) 393-0303

Special Needs: Yes

English, Spanish

M 9am - 6pm,

W 9am-6pm,

S 9am - 1pm

# DN20537 Singh Roy, Anurupa

NPI: 1073956447 LIC: DN20537

CERTIFICATIONS :

#015482

Coral Springs Smiles Dentistry

2929 N. University Dr, Ste 203


(954) 757-5353

Special Needs: Yes

English, Spanish, Hindi, Portuguese

M-T 9am-5pm

W-F 9am-5pm

S 9am - 2pm

# DN18901 Anand, Payal

NPI: 1801088919 LIC: DN18901

CERTIFICATIONS :

#009107

Crescent Dental, PA

5522 West Sample Road

Margate, FL 33073

(954) 968-4466

Special Needs: Yes

English, Spanish


W-F 9am-5pm

# DN20557 Morel, Adalgisa

NPI: 1831339308 LIC: DN20557

CERTIFICATIONS :

#013315

David Eugene, DDS, PLLC

2447 North State Road 7


(954) 733-9971

Special Needs: Yes

French, English, Creoles and Pidgins

French-based(other)

M-T 9am-5pm


S 9am - 1pm

# DN18594 Eugene, David

NPI: 1306080304 LIC: DN18594

CERTIFICATIONS :

#009473

Dental Excellence Corporation

7426 Wiles Road


www.dentalexcellence.org

(954) 255-3500

Special Needs: Yes


French-based(other), Vietnamese

M-T 9am-5pm

W-F 9am-5pm

# DN15112 Bui, Anthony

NPI: 1568479905 LIC: DN15112

CERTIFICATIONS :

#019656

Dental Excellence Partners



(954) 982-7645

Special Needs: No

English, Spanish

M-T 8am-6pm

W-F 8am-6pm

# DN20182 Aponte-Barrios, Secil

NPI: 1164714176 LIC: DN20182

CERTIFICATIONS :


NPI: 1235594961 LIC: DN21645

CERTIFICATIONS :

# DN22998 Boeras Garcia, Suibel

NPI: 1063939890 LIC: DN22998

CERTIFICATIONS :

# DN15630 Cano, Lourdes

NPI: 1093867947 LIC: DN15630

CERTIFICATIONS :

# DN21572 Carballo, Mauro

NPI: 1508200635 LIC: DN21572

CERTIFICATIONS :

# DN12668 Congote, Luis

NPI: 1679774426 LIC: DN12668

CERTIFICATIONS :

# DN20061 Cruz, Yarelie

NPI: 1124433305 LIC: DN20061

CERTIFICATIONS :

# DN24104 Gonzalez Junco, Luis

NPI: 1447819396 LIC: DN24104

CERTIFICATIONS :

# DN23700 Gonzalez, Carmen

NPI: 1285110718 LIC: DN23700

CERTIFICATIONS :

# DN23529 Gonzalez, Giovanni

NPI: 1417436189 LIC: DN23529

CERTIFICATIONS :

# DN19802 Hernandez, David

NPI: 1245593896 LIC: DN19802

CERTIFICATIONS :

# DN19522 Hernandez, Stephanie

NPI: 1669751871 LIC: DN19522

CERTIFICATIONS :

# DN11150 Reyes, Miguel

NPI: 1407948482 LIC: DN11150

CERTIFICATIONS :

# DN24069 Rodriguez Gonzalez,

David

NPI: 1548798960 LIC: DN24069

CERTIFICATIONS :

# DN21495 Streett, Rosario

NPI: 1801230768 LIC: DN21495

CERTIFICATIONS :

#020092

Dental Excellence Partners, LLC

4358 N Federal Hwy


(954) 776-3320

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm


NPI: 1235594961 LIC: DN21645

CERTIFICATIONS :

# DN22998 Boeras Garcia, Suibel

NPI: 1063939890 LIC: DN22998

CERTIFICATIONS :

# DN21572 Carballo, Mauro

NPI: 1508200635 LIC: DN21572

CERTIFICATIONS :

# DN12668 Congote, Luis

NPI: 1679774426 LIC: DN12668

CERTIFICATIONS :

# DN20061 Cruz, Yarelie

NPI: 1124433305 LIC: DN20061

CERTIFICATIONS :

# DN24104 Gonzalez Junco, Luis












June, 2020

06/15/2020 v.1(2018)





NPI: 1447819396 LIC: DN24104

CERTIFICATIONS :

# DN23700 Gonzalez, Carmen

NPI: 1285110718 LIC: DN23700

CERTIFICATIONS :

# DN19802 Hernandez, David

NPI: 1245593896 LIC: DN19802

CERTIFICATIONS :

# DN19522 Hernandez, Stephanie

NPI: 1669751871 LIC: DN19522

CERTIFICATIONS :

# DN11150 Reyes, Miguel

NPI: 1407948482 LIC: DN11150

CERTIFICATIONS :

# DN24069 Rodriguez Gonzalez,

David

NPI: 1548798960 LIC: DN24069

CERTIFICATIONS :

# DN21495 Streett, Rosario

NPI: 1801230768 LIC: DN21495

CERTIFICATIONS :

#008354

Dental Partners of Weston

2721 Executive Park Drive, Ste #1

Weston, FL 33331

(954) 385-5855

Special Needs: Yes

English, Spanish

M 9am - 5pm,

W 9am-5pm,

# DN12295 Collazo, Ralph

NPI: 1720155955 LIC: DN12295

CERTIFICATIONS :

#015845

Diaz Dental Group

2879 S. University Dr

Davie, FL 33328

(954) 474-2422

Special Needs: Yes

English, Spanish, French

M-T 10am-5pm

W 10am-7pm, Th 10am-5pm

# DN20123 Diaz, Yanet

NPI: 1215376934 LIC: DN20123

CERTIFICATIONS :

#020573

Diego Azar DMD PA

730 Riverside Drive


(954) 575-9800

Special Needs: Yes




S 9am - 2pm

# DN17121 Baghaei, Anoushirvan

NPI: 1922385640 LIC: DN17121

CERTIFICATIONS :


# DN21827 Garces, Sabrina

NPI: 1811314297 LIC: DN21827

CERTIFICATIONS :

#CHC9681

DOH - Broward County Health

Department

900 N.W. 31St Ave


(954) 467-4700

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

# DN12662 Castillo, Elzebir

NPI: 1396810883 LIC: DN12662

CERTIFICATIONS :


# DN19174 Khvilivitzky, Ester

NPI: 1255633541 LIC: DN19174

CERTIFICATIONS :

# DN19750 Muller, Ingrid

NPI: 1699023549 LIC: DN19750

CERTIFICATIONS :

# DN17007 Parra-Rabeya, Patricia

NPI: 1699953422 LIC: DN17007

CERTIFICATIONS :


#CHC9682


Department

2421 Sw 6Th Ave


(954) 467-4705

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm


NPI: 1396810883 LIC: DN12662

CERTIFICATIONS :



NPI: 1255633541 LIC: DN19174

CERTIFICATIONS :


NPI: 1699023549 LIC: DN19750

CERTIFICATIONS :


NPI: 1699953422 LIC: DN17007

CERTIFICATIONS :


#CHC9683


Department

601 West Atlantic Blvd, Second Floor


(954) 467-4700

Special Needs: Yes

English, Spanish

T 8am - 5pm

W 8am-5pm,


NPI: 1396810883 LIC: DN12662

CERTIFICATIONS :



NPI: 1255633541 LIC: DN19174

CERTIFICATIONS :


NPI: 1699023549 LIC: DN19750

CERTIFICATIONS :


NPI: 1699953422 LIC: DN17007

CERTIFICATIONS :


#CHC9684


Department

4105 Pembroke Road

Hollywood, FL 33021

(954) 467-4700

Special Needs: No

English, Spanish

M 8am - 5pm,


NPI: 1396810883 LIC: DN12662

CERTIFICATIONS :



NPI: 1255633541 LIC: DN19174

CERTIFICATIONS :


NPI: 1699023549 LIC: DN19750

CERTIFICATIONS :


NPI: 1699953422 LIC: DN17007

CERTIFICATIONS :


#CHC9685


Department

205 N.W. 6Th Ave


(954) 467-4705

Special Needs: No

English

T 8am - 5pm

W 8am-5pm,

# DN12662 Castillo, Elzebir*

NPI: 1396810883 LIC: DN12662

CERTIFICATIONS :


# DN19174 Khvilivitzky, Ester*

NPI: 1255633541 LIC: DN19174

CERTIFICATIONS :

# DN19750 Muller, Ingrid*

NPI: 1699023549 LIC: DN19750

CERTIFICATIONS :

# DN17007 Parra-Rabeya, Patricia*

NPI: 1699953422 LIC: DN17007

CERTIFICATIONS :













June, 2020

06/15/2020 v.1(2018)





#007554

Dr. Ira Goldman

2100 East Hallendale Beach Blvd, Ste

# 409

Hallandale, FL 33009

(954) 456-9844

Special Needs: Yes

English


W-Th 9am-5pm

# DN5717 Goldman, Ira*

NPI: 1326113937 LIC: DN5717

CERTIFICATIONS :

#006661

Dr. Michael Barnard, DDS PA &

Assoc

1209 W. Broward Blvd

Ft Lauderdale, FL 33312

www.browarddds.com

(954) 763-3358

Special Needs: Yes

French, Russian, Creoles and Pidgins

English-based(other), Serbian,

Spanish

T 7am - 5pm


# DN9973 Barnard, Michael

NPI: 1487752861 LIC: DN9973

CERTIFICATIONS :

# DN20101 Licina, Zeljka

NPI: 1013263292 LIC: DN20101

CERTIFICATIONS :

#020227

Family Dental Associates PA

6130 West Atlantic Blvd

Margate, FL 33063

(954) 973-0990

Special Needs: Yes


(other)

M-T 8am-5pm

W-Th 8am-5pm

# DN17643 Blackmore, Sofia

NPI: 1427387687 LIC: DN17643

CERTIFICATIONS :

# DN10097 Lewis, Brad

NPI: 1376567685 LIC: DN10097

CERTIFICATIONS :

# DN19201 Mingel, Marc

NPI: 1831402957 LIC: DN19201

CERTIFICATIONS :

# DN13900 Polasky, Steven

NPI: 1366583312 LIC: DN13900

CERTIFICATIONS :

#010038

Family Dental Care

1600 N. State Rd 7, Ste 400

Lauderhill, FL 33313

(954) 581-9228

Special Needs: Yes


M-T 9am-5pm

W-Th 9am-5pm

S 9am - 1pm

# DN18305 Akel, Bassil

NPI: 1700040557 LIC: DN18305

CERTIFICATIONS :

#008950

Family Smile Dental

701 Promenade Drive Ste 102


(954) 272-9250

Special Needs: Yes

English, Spanish

M 12pm - 7pm, T 9am - 5pm

W-Th 9am-5pm

# DN17384 Mujtaba, Moneeze

NPI: 1609926310 LIC: DN17384

CERTIFICATIONS :

#013821

Gateway Dental Inc

6720 Pines Blvd.


(305) 856-2300

Special Needs: Yes

Spanish, English

M-T 9am-5pm

W-Th 9am-5pm

# DN18302 Herrera, Victoria

NPI: 1114185550 LIC: DN18302

CERTIFICATIONS :

# DN15212 Miranda, Pablo

NPI: 1023036365 LIC: DN15212

CERTIFICATIONS :

# DN15477 Perrotti, Steven

NPI: 1144249780 LIC: DN15477

CERTIFICATIONS :

# DN22991 Santiesteban, Aymara

NPI: 1265826168 LIC: DN22991

CERTIFICATIONS :

#022831

Gentle Teeth and Braces of

Weston

2751 Executive Park Drive


(954) 217-0288

Special Needs: Yes

English, Spanish

M-T 8am-8pm

W-Th 8am-8pm

# DN22685 Perez-Borroto Rodrigez,

Daylis

NPI: 1790215309 LIC: DN22685

CERTIFICATIONS :

#012662

Gentle Teeth of Pembroke Pines

12251 Taft Street Ste 301


www.gentleteeth.com

(954) 437-7077

Special Needs: Yes

Spanish, English

M-T 9am-7pm

W-Th 9am-7pm

S 8am - 1pm

# DN23446 Baddaloo, Reshma

NPI: 1043704026 LIC: DN23446

CERTIFICATIONS :


#010848


4660 W Hillsboro Blvd, Ste 7

Coconut Creek, FL 33073

(954) 428-1803

Special Needs: Yes


French-based(other), Portuguese

M-T 8am-5pm

W-F 8am-5pm

S 9am - 1pm

# 058109 Gonvcalves Cordero,

Jhezanuel Carolina

NPI: 1477979557 LIC: 058109

CERTIFICATIONS :

# DN20973 Martinez, Amy

NPI: 1124382866 LIC: DN20973

CERTIFICATIONS :

# DN22938 Sanchez, Diego

NPI: 1902329816 LIC: DN22938

CERTIFICATIONS :

#010861


2905 Sw 160Th Ave

Miramar, FL 33027

(954) 392-7051

Special Needs: Yes

English

M-T 8am-5pm

W-F 8am-5pm

# DN19020 De La Rua, Lissette

NPI: 1619297892 LIC: DN19020

CERTIFICATIONS :

# DN21238 Yanes, Marnie

NPI: 1407236052 LIC: DN21238

CERTIFICATIONS :

#010865


140 South University Drive


(954) 431-0004

Special Needs: Yes

English, Spanish, French

M-T 8am-5pm

W-F 8am-5pm

S 8am - 12pm

# DN20006 Arocha, Miguelina

NPI: 1407081540 LIC: DN20006

CERTIFICATIONS :

#010870












June, 2020

06/15/2020 v.1(2018)






4537 Weston Road

Weston, FL 33331

(954) 349-1289

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 7am-3pm

S 8am - 12pm

# DN19020 De La Rua, Lissette

NPI: 1619297892 LIC: DN19020

CERTIFICATIONS :

# DN20339 Edwards, Laura

NPI: 1629400098 LIC: DN20339

CERTIFICATIONS :

#010987


2365 N University Dr.


(954) 755-1014

Special Needs: Yes


English-based(other)

M-T 8am-5pm

Th-F 8am-5pm

# DN20006 Arocha, Miguelina

NPI: 1407081540 LIC: DN20006

CERTIFICATIONS :

# 058109 Gonvcalves Cordero,

Jhezanuel Carolina

NPI: 1477979557 LIC: 058109

CERTIFICATIONS :

#016226


9601 W. Atlantic Blvd


(954) 753-7400

Special Needs: Yes


English-based(other)

M-T 8am-5pm

W-F 8am-5pm

S 9am - 1pm

# DN21396 Dagan, Shachar

NPI: 1447632542 LIC: DN21396

CERTIFICATIONS :

#017850

Great Smiles Dental of Fort

Lauderdale

2633 E. Commercial Blvd Ste B


(954) 530-5352

Special Needs: Yes

English, Spanish

M-T 9am-5pm

W-F 9am-5pm

S 9am - 1pm

# DN19482 Murcia, Marcela

NPI: 1588952261 LIC: DN19482

CERTIFICATIONS :

#016656

Greenberg Dental & Orthodontics

1739 Commercial Blvd


(954) 368-9891

Special Needs: Yes

English, Spanish



7am-3pm

# DN12124 Barrett, Steven*

NPI: 1811957046 LIC: DN12124

CERTIFICATIONS :

# DN18753 Daneshpajouh, Sara

NPI: 1982836003 LIC: DN18753

CERTIFICATIONS :

# DN22704 Foreman, Kathleen

NPI: 1407377724 LIC: DN22704

CERTIFICATIONS :

# DN7501 Greenberg, Andrew*

NPI: 1740240696 LIC: DN7501

CERTIFICATIONS :

# DN23796 Lajevardi, Navid

NPI: 1194212472 LIC: DN23796

CERTIFICATIONS :

# DN24103 Neyra, Arlet*

NPI: 1730747833 LIC: DN24103

CERTIFICATIONS :

# DN22692 Nguyen, Josie*

NPI: 1548790801 LIC: DN22692

CERTIFICATIONS :


• Oral / Enteral Sedation

# DN23069 Piccione, Francesco

NPI: 1295274835 LIC: DN23069

CERTIFICATIONS :

# DN22932 Rincon, Karolina

NPI: 1790293595 LIC: DN22932

CERTIFICATIONS :

# DN20824 Scarlett, Francesca

NPI: 1124437884 LIC: DN20824

CERTIFICATIONS :

# DN23211 Walker, Lindsay

NPI: 1093238842 LIC: DN23211

CERTIFICATIONS :

#016725


7165 W. Oakland Park Blvd

Lauderhill, FL 33313

(954) 289-2393

Special Needs: Yes

Spanish

M-T 7am-3pm

W-Th 10am-6pm

# DN12124 Barrett, Steven

NPI: 1811957046 LIC: DN12124

CERTIFICATIONS :


NPI: 1982836003 LIC: DN18753

CERTIFICATIONS :


NPI: 1407377724 LIC: DN22704

CERTIFICATIONS :

# DN7501 Greenberg, Andrew

NPI: 1740240696 LIC: DN7501

CERTIFICATIONS :


NPI: 1194212472 LIC: DN23796

CERTIFICATIONS :


NPI: 1730747833 LIC: DN24103

CERTIFICATIONS :


NPI: 1548790801 LIC: DN22692

CERTIFICATIONS :




NPI: 1295274835 LIC: DN23069

CERTIFICATIONS :


NPI: 1790293595 LIC: DN22932

CERTIFICATIONS :


NPI: 1124437884 LIC: DN20824

CERTIFICATIONS :

# DN17455 Stein, Stacy

NPI: 1467637561 LIC: DN17455

CERTIFICATIONS :


NPI: 1093238842 LIC: DN23211

CERTIFICATIONS :

#017045


6821 Taft Street

Hollywood, FL 33024

(954) 399-3826

Special Needs: Yes

English, Spanish


W-F 8am-4pm


NPI: 1811957046 LIC: DN12124

CERTIFICATIONS :


NPI: 1982836003 LIC: DN18753

CERTIFICATIONS :


NPI: 1407377724 LIC: DN22704

CERTIFICATIONS :


NPI: 1740240696 LIC: DN7501

CERTIFICATIONS :

# DN22858 Kang, Youngjn

NPI: 1538680053 LIC: DN22858

CERTIFICATIONS :



NPI: 1194212472 LIC: DN23796

CERTIFICATIONS :

# DN22658 Laurey, Violet

NPI: 1194254789 LIC: DN22658

CERTIFICATIONS :












June, 2020

06/15/2020 v.1(2018)







NPI: 1730747833 LIC: DN24103

CERTIFICATIONS :


NPI: 1548790801 LIC: DN22692

CERTIFICATIONS :



# DN22862 Patel, Mitul

NPI: 1679094197 LIC: DN22862

CERTIFICATIONS :

# DN20239 Phan, Christine

NPI: 1871933846 LIC: DN20239

CERTIFICATIONS :



NPI: 1295274835 LIC: DN23069

CERTIFICATIONS :


NPI: 1790293595 LIC: DN22932

CERTIFICATIONS :


NPI: 1124437884 LIC: DN20824

CERTIFICATIONS :

# DN22755 Shah, Priya

NPI: 1528584919 LIC: DN22755

CERTIFICATIONS :


NPI: 1467637561 LIC: DN17455

CERTIFICATIONS :


NPI: 1093238842 LIC: DN23211

CERTIFICATIONS :

#017408



Margate, FL 33063

(954) 947-8765

Special Needs: Yes

English, Spanish


Th-F 7am-3pm


NPI: 1811957046 LIC: DN12124

CERTIFICATIONS :


NPI: 1982836003 LIC: DN18753

CERTIFICATIONS :


NPI: 1407377724 LIC: DN22704

CERTIFICATIONS :


NPI: 1740240696 LIC: DN7501

CERTIFICATIONS :


NPI: 1194212472 LIC: DN23796

CERTIFICATIONS :


NPI: 1730747833 LIC: DN24103

CERTIFICATIONS :


NPI: 1548790801 LIC: DN22692

CERTIFICATIONS :




NPI: 1295274835 LIC: DN23069

CERTIFICATIONS :


NPI: 1790293595 LIC: DN22932

CERTIFICATIONS :


NPI: 1124437884 LIC: DN20824

CERTIFICATIONS :


NPI: 1467637561 LIC: DN17455

CERTIFICATIONS :


NPI: 1093238842 LIC: DN23211

CERTIFICATIONS :

#017046

Greenberg Dental & Orthodontics,

PA

8688 Griffin Road


(954) 399-7814

Special Needs: Yes

English, Spanish


W-Th 9am-5pm


NPI: 1811957046 LIC: DN12124

CERTIFICATIONS :


NPI: 1982836003 LIC: DN18753

CERTIFICATIONS :


NPI: 1407377724 LIC: DN22704

CERTIFICATIONS :


NPI: 1740240696 LIC: DN7501

CERTIFICATIONS :

# DN22858 Kang, Youngjn

NPI: 1538680053 LIC: DN22858

CERTIFICATIONS :



NPI: 1194212472 LIC: DN23796

CERTIFICATIONS :

# DN22658 Laurey, Violet

NPI: 1194254789 LIC: DN22658

CERTIFICATIONS :



NPI: 1730747833 LIC: DN24103

CERTIFICATIONS :


NPI: 1548790801 LIC: DN22692

CERTIFICATIONS :



# DN22862 Patel, Mitul

NPI: 1679094197 LIC: DN22862

CERTIFICATIONS :

# DN20239 Phan, Christine

NPI: 1871933846 LIC: DN20239

CERTIFICATIONS :



NPI: 1295274835 LIC: DN23069

CERTIFICATIONS :


NPI: 1790293595 LIC: DN22932

CERTIFICATIONS :


NPI: 1124437884 LIC: DN20824

CERTIFICATIONS :

# DN22755 Shah, Priya

NPI: 1528584919 LIC: DN22755

CERTIFICATIONS :


NPI: 1467637561 LIC: DN17455

CERTIFICATIONS :


NPI: 1093238842 LIC: DN23211

CERTIFICATIONS :

#021445

James Kerns DMD PLLC

6905 W. Broward Blvd. Ste 101


smiledesigndentalpl.com

(954) 641-0414

Special Needs: Yes

English, Spanish

M-T 9am-5pm

W-F 9am-5pm

S 9am - 2pm

# DN22304 Kesman, Paola

NPI: 1508313578 LIC: DN22304

CERTIFICATIONS :

#016763

Jennifer Garcia DDS

3501 Nw 84Th Ave

Sunrise, FL 33351

(954) 741-2323

Special Needs: Yes

English, Spanish

M-T 8am-5pm


# DN21347 Garcia-Avalo, Jennifer

NPI: 1972985257 LIC: DN21347

CERTIFICATIONS :


#023228

JM Dental Group Inc



(954) 432-8000

Special Needs: Yes

English, Spanish

M-T 9am-5pm

W-F 9am-5pm

# DN14451 Hernandez, Norberto












June, 2020

06/15/2020 v.1(2018)





NPI: 1285693267 LIC: DN14451

CERTIFICATIONS :

#012912

Juan Carlos Flores DMD


Margate, FL 33063

(954) 971-6115

Special Needs: Yes

English, Spanish

T 9am - 5pm

# DN17732 Flores, Juan*

NPI: 1548459803 LIC: DN17732

CERTIFICATIONS :

#016230

Kid's Dental Place

333 Nw 70Th Ave #101


kidsdentalfl.com

(954) 472-3118

Special Needs: Yes


French-based(other), Portuguese

M-T 8am-6pm

W-F 8am-6pm

S 8am - 1pm

# DN20926 Woodruff, Joshua

NPI: 1013331644 LIC: DN20926

CERTIFICATIONS :

#020216

Kids Healthy Smiles

2722 Ne 1St Street, Ste 1


www.kidshealthysmiles.com

(954) 590-8454

Special Needs: Yes

English, Spanish, French, Portuguese

M-T 8am-5pm

Th-F 8am-5pm

S 9am - 2pm

# DN21446 Granada-Ramirez, Erika

NPI: 1134503329 LIC: DN21446

CERTIFICATIONS :


# DN19419 Tchou, Luisa

NPI: 1124315270 LIC: DN19419

CERTIFICATIONS :


#013365

Lakes Mall Dental Center, PA

11401 Pines Blvd, Ste 220


(954) 432-5515

Special Needs: No

English, Spanish

T 10am - 4pm

W 12pm-7pm, Th 10am-4pm,F

12pm-7pm

S 9am - 3pm

# DN19377 Calderon, Erik

NPI: 1942596416 LIC: DN19377

CERTIFICATIONS :


# DN22454 Dominguez, Ivelisse

NPI: 1386098655 LIC: DN22454

CERTIFICATIONS :

#021614

Lauderdale Dentistry For Kids

LLC

4500 N State Road 7, Ste 101


(954) 261-7551

Special Needs: Yes

English, Spanish



8am-2pm

# DN20549 Haghighi, Azin

NPI: 1730512781 LIC: DN20549

CERTIFICATIONS :


# DN21007 Tijerino, David

NPI: 1538397492 LIC: DN21007

CERTIFICATIONS :


#017607

Mercy Dental Group

3172 S. University Dr

Hollywood, FL 33025

(954) 404-6877

Special Needs: Yes

English, Spanish



9am-2pm

# DN21842 Alvarado, Yailen

NPI: 1700235363 LIC: DN21842

CERTIFICATIONS :

# DN21847 Diaz, Jany

NPI: 1659729598 LIC: DN21847

CERTIFICATIONS :

#016573

Mini Mouths Dentistry

700 N. Hiatus Rd Ste 101


www.minimouths.com

(754) 217-4633

Special Needs: Yes


M-T 8am-5pm

W-F 8am-5pm

# DN20969 Agudelo, Monica

NPI: 1578961751 LIC: DN20969

CERTIFICATIONS :


NPI: 1134503329 LIC: DN21446

CERTIFICATIONS :



NPI: 1831339308 LIC: DN20557

CERTIFICATIONS :

# DN24076 Savioli, Cynthia

NPI: 1336677756 LIC: DN24076

CERTIFICATIONS :

#016172

Mini Mouths Dentistry for

Children

5481 N. University Dr Ste 102


(954) 575-5488

Special Needs: Yes


M-T 8am-5pm

W-Th 8am-5pm

# DN20969 Agudelo, Monica

NPI: 1578961751 LIC: DN20969

CERTIFICATIONS :


NPI: 1134503329 LIC: DN21446

CERTIFICATIONS :



NPI: 1831339308 LIC: DN20557

CERTIFICATIONS :

# DN24076 Savioli, Cynthia

NPI: 1336677756 LIC: DN24076

CERTIFICATIONS :

# DN19419 Tchou, Luisa

NPI: 1124315270 LIC: DN19419

CERTIFICATIONS :


#010345

NSU- BGMC Oral & Maxillofacial

Surgery

1600 S. Andrews Ave, 3Rd Floor


(954) 355-5703

Special Needs: Yes

English, Spanish

M 1pm - 5pm,

W-F 9am-5pm

# DN13419 Ede-Nichols, Diane

NPI: 1225145683 LIC: DN13419

CERTIFICATIONS :

# DN22197 Khatib, Adel

NPI: 1235582503 LIC: DN22197

CERTIFICATIONS :

#010341

NSU- JDCH Center for

Cranio-Facial Pediatric & Dental

Care

3501 Johnson Street, Ste 200

Hollywood, FL 33021

(954) 262-2187

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

# DN13419 Ede-Nichols, Diane

NPI: 1225145683 LIC: DN13419

CERTIFICATIONS :

# DN22197 Khatib, Adel












June, 2020

06/15/2020 v.1(2018)





NPI: 1235582503 LIC: DN22197

CERTIFICATIONS :

#018790

Oral 1 Dental Group

7153 N Pine Island Rd


(954) 532-3247

Special Needs: Yes

English, Spanish

M-T 9am-5pm

W-Th 9am-5pm

# DN20878 Londono, Laura

NPI: 1679982839 LIC: DN20878

CERTIFICATIONS :

#007926

Pediatric Dental Centers of

Broward



(954) 341-0002

Special Needs: Yes

English, Spanish

M-T 8am-5pm

W-F 8am-5pm

S 8am - 2pm

# DN17647 Bueno, Rosa

NPI: 1972649218

florida medicaid child - client liberty dental plan...prairie dental center 6320 sw 13th st...

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