Provider Demographics
NPI:1023263621
Name:CABANILLAS, JUAN J (DDS)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:J
Last Name:CABANILLAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2717 E OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1664
Mailing Address - Country:US
Mailing Address - Phone:954-566-6200
Mailing Address - Fax:954-566-6204
Practice Address - Street 1:3911 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3902
Practice Address - Country:US
Practice Address - Phone:561-498-0050
Practice Address - Fax:561-498-0841
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN138831223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics