Provider Demographics
NPI:1326632613
Name:ALLURE DENTAL OF HOLLYWOOD PLLC
Entity Type:Organization
Organization Name:ALLURE DENTAL OF HOLLYWOOD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-810-6226
Mailing Address - Street 1:8580 STIRLING RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8206
Mailing Address - Country:US
Mailing Address - Phone:954-500-0102
Mailing Address - Fax:954-500-0101
Practice Address - Street 1:8580 STIRLING RD STE 101
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8206
Practice Address - Country:US
Practice Address - Phone:954-500-0102
Practice Address - Fax:954-500-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid