Provider Demographics
NPI:1760988802
Name:TRINITY DENTAL ARTS PLLC
Entity Type:Organization
Organization Name:TRINITY DENTAL ARTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XHOANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GJELAJ-VARFI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-228-6846
Mailing Address - Street 1:11105 TRINITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4538
Mailing Address - Country:US
Mailing Address - Phone:727-228-6846
Mailing Address - Fax:727-375-8089
Practice Address - Street 1:11105 TRINITY BLVD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4538
Practice Address - Country:US
Practice Address - Phone:727-228-6846
Practice Address - Fax:727-375-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18307261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental