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

Pines Dental Village Corp

Organization General Practice Dentistry · NPI 1205706074

Pines Dental Village Corp provides General Practice Dentistry in Pembroke Pines, Florida. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12558 Pines Blvd
Pembroke Pines, FL 33027-1713
Phone: (954) 639-6998
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1205706074
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Liveisys Pedraza — Owner · (786) 337-1013
NPI enumeratedNovember 7, 2025
Last updated in NPPESNovember 7, 2025
Certification dateNovember 7, 2025
Mailing address12558 Pines Blvd, Pembroke Pines, FL 33027-1713

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