Provider Demographics
NPI:1306680889
Name:WILENSKY, SARAH (DMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WILENSKY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 SW 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3823
Mailing Address - Country:US
Mailing Address - Phone:954-599-1612
Mailing Address - Fax:
Practice Address - Street 1:8777 HYPOLUXO RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-5317
Practice Address - Country:US
Practice Address - Phone:561-448-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice