Provider Demographics
NPI:1427196716
Name:ROTHMAN, VICTORIA ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANN
Last Name:ROTHMAN
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 1:12197 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5258
Mailing Address - Country:US
Mailing Address - Phone:305-423-4130
Mailing Address - Fax:
Practice Address - Street 1:12197 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-5258
Practice Address - Country:US
Practice Address - Phone:305-423-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics