Provider Demographics
NPI:1184875544
Name:TRIFUNOVIC, LADILIA (DMD)
Entity type:Individual
Prefix:DR
First Name:LADILIA
Middle Name:
Last Name:TRIFUNOVIC
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE E-112
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6741
Mailing Address - Country:US
Mailing Address - Phone:954-749-2600
Mailing Address - Fax:
Practice Address - Street 1:7800 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE E-112
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6741
Practice Address - Country:US
Practice Address - Phone:954-749-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 184921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice