Provider Demographics
NPI:1518655257
Name:VITAL DENT, PLLC
Entity Type:Organization
Organization Name:VITAL DENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:DR
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-794-1897
Mailing Address - Street 1:9721 KENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2764
Mailing Address - Country:US
Mailing Address - Phone:305-897-1897
Mailing Address - Fax:
Practice Address - Street 1:8880 SW 97TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1937
Practice Address - Country:US
Practice Address - Phone:305-794-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental