Provider Demographics
NPI:1518372994
Name:RIBEIRO, FABIANE (DMD)
Entity Type:Individual
Prefix:DR
First Name:FABIANE
Middle Name:
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20000 E COUNTRY CLUB DR
Mailing Address - Street 2:#TS10
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3004
Mailing Address - Country:US
Mailing Address - Phone:305-496-0370
Mailing Address - Fax:
Practice Address - Street 1:19016 NE 29TH AVE
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2823
Practice Address - Country:US
Practice Address - Phone:305-496-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist