Provider Demographics
NPI:1023449071
Name:CHASE DENTAL SLEEPCARE OF AVENTURA LLC
Entity type:Organization
Organization Name:CHASE DENTAL SLEEPCARE OF AVENTURA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:BISTRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-933-2501
Mailing Address - Street 1:18171 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2535
Mailing Address - Country:US
Mailing Address - Phone:305-933-2501
Mailing Address - Fax:305-933-0429
Practice Address - Street 1:18171 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2535
Practice Address - Country:US
Practice Address - Phone:305-933-2501
Practice Address - Fax:305-933-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00119361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty