Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Countryside Dental Assoc Inc

Organization Dentist · NPI 1699934646

Countryside Dental Assoc Inc provides Dentist services in Cooper City, Florida. Licensed in Florida. Registered with an NPI since 2008.

Licensed in
FL
In the registry since
2008
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5810 S Flamingo Rd
Cooper City, FL 33330-3237 Not confirmed with CMS for 15 years — call before visiting
Phone: (954) 434-3229
Fax: (954) 680-6254
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN8648
Dentist Taxonomy 122300000X · Licence DN8648 (FL)
Dentist Taxonomy 122300000X · Licence DN18677 (FL)
General Practice Dentistry Taxonomy 1223G0001X · Licence DN18066 (FL)

Record details

NPI number1699934646
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Ancona — President/Dentist · (954) 434-3229
NPI enumeratedJune 5, 2008
Last updated in NPPESJanuary 20, 2011
Mailing address5810 S. Flamingo Rd, Cooper City, FL 33330-3237

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