Provider Demographics
NPI:1093550907
Name:HEMELBERG, CHRISTIAN AUGUSTO (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:AUGUSTO
Last Name:HEMELBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15454 SW 143RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6031
Mailing Address - Country:US
Mailing Address - Phone:305-968-8739
Mailing Address - Fax:
Practice Address - Street 1:15454 SW 143RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6031
Practice Address - Country:US
Practice Address - Phone:305-968-8739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL292841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice