Provider Demographics
NPI:1346071073
Name:JM HOSSEINI DMD PLLC
Entity type:Organization
Organization Name:JM HOSSEINI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOSSEINI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-448-9072
Mailing Address - Street 1:1040 WESTON RD STE 225
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1912
Mailing Address - Country:US
Mailing Address - Phone:954-389-9500
Mailing Address - Fax:
Practice Address - Street 1:1040 WESTON RD STE 225
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1912
Practice Address - Country:US
Practice Address - Phone:954-389-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1396134417OtherDENTIST