Provider Demographics
NPI:1245326016
Name:OKLIN, RONALD NMI (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:NMI
Last Name:OKLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:NMI
Other - Last Name:OKLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6805 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2620
Mailing Address - Country:US
Mailing Address - Phone:954-989-6950
Mailing Address - Fax:954-989-6962
Practice Address - Street 1:6805 PEMBROKE RD
Practice Address - Street 2:NONE
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33023-2620
Practice Address - Country:US
Practice Address - Phone:954-989-6950
Practice Address - Fax:954-989-6962
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice