Provider Demographics
NPI:1104108018
Name:DUBINER, DAVID EVAN (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EVAN
Last Name:DUBINER
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 1:2600 S UNIVERSITY DR
Mailing Address - Street 2:APT 226
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1462
Mailing Address - Country:US
Mailing Address - Phone:850-322-2498
Mailing Address - Fax:
Practice Address - Street 1:2600 S UNIVERISTY DR
Practice Address - Street 2:APT 226
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328
Practice Address - Country:US
Practice Address - Phone:850-322-2498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN194201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty