Provider Demographics
NPI:1790990208
Name:QUINONES, LUIS (DMD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 WA KEE NA DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2437
Mailing Address - Country:US
Mailing Address - Phone:305-858-3178
Mailing Address - Fax:
Practice Address - Street 1:900 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2916
Practice Address - Country:US
Practice Address - Phone:305-861-7222
Practice Address - Fax:305-861-2300
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist