Provider Demographics
NPI:1952283632
Name:INSPIRED DENTAL PA
Entity type:Organization
Organization Name:INSPIRED DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUERTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:321-603-3030
Mailing Address - Street 1:1915 MAGUIRE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-7938
Mailing Address - Country:US
Mailing Address - Phone:321-603-3030
Mailing Address - Fax:321-603-3040
Practice Address - Street 1:1915 MAGUIRE RD STE 101
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-7938
Practice Address - Country:US
Practice Address - Phone:321-603-3030
Practice Address - Fax:321-603-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental