Provider Demographics
NPI:1104213909
Name:ARNEDO, JOHANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:
Last Name:ARNEDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 NW 109TH TER
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6430
Mailing Address - Country:US
Mailing Address - Phone:954-319-0253
Mailing Address - Fax:
Practice Address - Street 1:100 N STATE ROAD 7
Practice Address - Street 2:SUITE 200 A
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4520
Practice Address - Country:US
Practice Address - Phone:954-933-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN210791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice