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

Pembroke Lakes Mall Dental PA

Organization General Practice Dentistry · NPI 1144945882

Pembroke Lakes Mall Dental PA provides General Practice Dentistry in Pembroke Pines, Florida. Registered with an NPI since 2022.

In the registry since
2022
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
Phone: (954) 573-1400
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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

Record details

NPI number1144945882
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rostislav Krasnov — Owner · (954) 573-1400
NPI enumeratedOctober 5, 2022
Last updated in NPPESOctober 12, 2022
Certification dateOctober 12, 2022
Mailing address11401 Pines Blvd Ste 220, Pembroke Pines, FL 33026-4104

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