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

Pembroke Lakes Mall Dental PA

Organization General Practice Dentistry · NPI 1144945882

Pembroke Lakes Mall Dental PA is a 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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