Provider Demographics
NPI:1942657796
Name:DENTAL VIEW, LLC
Entity Type:Organization
Organization Name:DENTAL VIEW, LLC
Other - Org Name:DENTAL VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:T
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:863-594-7032
Mailing Address - Street 1:814 SPRING LAKE SQ
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-1338
Mailing Address - Country:US
Mailing Address - Phone:863-268-2300
Mailing Address - Fax:863-268-2399
Practice Address - Street 1:814 SPRING LAKE SQ
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-1338
Practice Address - Country:US
Practice Address - Phone:863-268-2300
Practice Address - Fax:863-268-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013444500Medicaid