Provider Demographics
NPI:1851089502
Name:DREAM SMILES DENTAL CORP
Entity Type:Organization
Organization Name:DREAM SMILES DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEYANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-515-4270
Mailing Address - Street 1:5975 SUNSET DR STE 107
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5198
Mailing Address - Country:US
Mailing Address - Phone:305-605-5565
Mailing Address - Fax:
Practice Address - Street 1:5975 SUNSET DR STE 107
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5198
Practice Address - Country:US
Practice Address - Phone:305-605-5565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty