Provider Demographics
NPI:1912683624
Name:ESCALANTE, DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:ESCALANTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:ESCALANTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:16340 S POST RD APT 303
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3554
Mailing Address - Country:US
Mailing Address - Phone:754-465-3084
Mailing Address - Fax:
Practice Address - Street 1:16340 S POST RD APT 303
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3554
Practice Address - Country:US
Practice Address - Phone:754-465-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH28793124Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No124Q00000XDental ProvidersDental Hygienist