Provider Demographics
NPI:1710502554
Name:DIRECT DENTAL SOLUTIONS NORTH PLLC
Entity Type:Organization
Organization Name:DIRECT DENTAL SOLUTIONS NORTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-308-5854
Mailing Address - Street 1:18331 PINES BLVD # 206
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1421
Mailing Address - Country:US
Mailing Address - Phone:888-417-3211
Mailing Address - Fax:888-417-3216
Practice Address - Street 1:18331 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1421
Practice Address - Country:US
Practice Address - Phone:954-937-1840
Practice Address - Fax:888-417-3216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty