Provider Demographics
NPI:1184658585
Name:VARON, DINA K (DDS)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:K
Last Name:VARON
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 1:16389 SW 77TH CT
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-0703
Mailing Address - Country:US
Mailing Address - Phone:305-251-1616
Mailing Address - Fax:
Practice Address - Street 1:8750 SW 144TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:VILLAGE OF PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33176-7296
Practice Address - Country:US
Practice Address - Phone:305-969-3122
Practice Address - Fax:305-232-5193
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN103201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69191Medicare UPIN
FL60034Medicare ID - Type Unspecified