Provider Demographics
NPI:1366702425
Name:DENNIS R. RINALDI DMD PA
Entity type:Organization
Organization Name:DENNIS R. RINALDI DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:RINALDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-334-4090
Mailing Address - Street 1:710 NE JENSEN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4752
Mailing Address - Country:US
Mailing Address - Phone:772-334-4090
Mailing Address - Fax:
Practice Address - Street 1:710 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4752
Practice Address - Country:US
Practice Address - Phone:772-334-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN101381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty