Provider Demographics
NPI:1992527980
Name:HERRERA DENTAL DDS INC
Entity type:Organization
Organization Name:HERRERA DENTAL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA CASAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-502-6733
Mailing Address - Street 1:9766 SW 24TH ST
Mailing Address - Street 2:STE 6
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7575
Mailing Address - Country:US
Mailing Address - Phone:305-995-0542
Mailing Address - Fax:305-995-0543
Practice Address - Street 1:22129 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-2840
Practice Address - Country:US
Practice Address - Phone:305-859-3401
Practice Address - Fax:786-776-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty