Organization · Type 2 NPI

Nova Southeastern University

Pediatric Dentistry · Wilton Manors, FL

NPI number 1275878241 Active

Practice location

819 NE 26th St
Wilton Manors, FL 33305-1239

Call (954) 567-5650 Map

Fax (954) 561-8556

Mailing address

PO Box 290370
Davie, FL 33329-0370

Specialties and licenses

TaxonomyCodeLicense
Endodontics 1223E0200XNone listed
General Practice Dentistry 1223G0001XNone listed
Pediatric Dentistry Primary 1223P0221XNone listed
Periodontics 1223P0300XNone listed
Prosthodontics 1223P0700XNone listed
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400XNone listed
Dental Hygienist 124Q00000XNone listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

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About NPI 1275878241

Nova Southeastern University's National Provider Identifier is 1275878241, issued on Dec 3, 2012. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Wilton Manors, FL. The record was last updated on Oct 29, 2026.