Provider Demographics
NPI:1083365977
Name:JONARI DENTAL LLC
Entity Type:Organization
Organization Name:JONARI DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:STREETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-372-5318
Mailing Address - Street 1:3800 N. UNIVERSITY DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:754-296-3800
Mailing Address - Fax:
Practice Address - Street 1:3800 N. UNIVERSITY DR
Practice Address - Street 2:SUITE 203
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:754-296-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty