Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Lakes Mall Dental Center , PA

Organization General Practice Dentistry · NPI 1063757912

Lakes Mall Dental Center , PA provides General Practice Dentistry in Pembroke Pines, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11401 Pines Blvd Ste 220
Pembroke Pines, FL 33026-4104 Not confirmed with CMS for 13 years — call before visiting
Phone: (954) 432-5515
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 19377 (FL)

Record details

NPI number1063757912
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Erik Calderon — President · (305) 951-9988
NPI enumeratedDecember 4, 2012
Last updated in NPPESDecember 4, 2012
Mailing address1830 S Ocean Dr Apt 2204, Hallandale Beach, FL 33009-7695

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