Provider Demographics
NPI:1497165518
Name:DANIELLE S. JAFFE, DDS P.A.
Entity Type:Organization
Organization Name:DANIELLE S. JAFFE, DDS P.A.
Other - Org Name:BROWARD ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-319-9423
Mailing Address - Street 1:1312 E BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2136
Mailing Address - Country:US
Mailing Address - Phone:954-463-3636
Mailing Address - Fax:954-463-2320
Practice Address - Street 1:1312 E BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2136
Practice Address - Country:US
Practice Address - Phone:954-463-3636
Practice Address - Fax:954-463-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN202701223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty