Provider Demographics
NPI:1366228488
Name:DENTAL EEXPERTS OF FLORIDA
Entity type:Organization
Organization Name:DENTAL EEXPERTS OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELJABALI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-943-1790
Mailing Address - Street 1:8108 RIVER MONT WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-7921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 RICKENBACKER DR
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5332
Practice Address - Country:US
Practice Address - Phone:813-943-1790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental