Provider Demographics
NPI:1457751653
Name:SERENITY DENTAL @ ZHILLS
Entity Type:Organization
Organization Name:SERENITY DENTAL @ ZHILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NILA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-909-8400
Mailing Address - Street 1:6310 FORT KING RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-2531
Mailing Address - Country:US
Mailing Address - Phone:813-715-0055
Mailing Address - Fax:813-715-0077
Practice Address - Street 1:1849 COLLIER PKWY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-8718
Practice Address - Country:US
Practice Address - Phone:813-909-8400
Practice Address - Fax:813-909-7060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN160431223G0001X
FLDN164151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty