Provider Demographics
NPI:1174916050
Name:SUNHEART DENTAL
Entity type:Organization
Organization Name:SUNHEART DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:HILLMAN
Authorized Official - Last Name:PINNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-294-2363
Mailing Address - Street 1:628 SW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-1024
Mailing Address - Country:US
Mailing Address - Phone:954-294-2363
Mailing Address - Fax:
Practice Address - Street 1:801 S FEDERAL HWY
Practice Address - Street 2:SUITE #829
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-4374
Practice Address - Country:US
Practice Address - Phone:954-925-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17610261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental