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

Sawgrass Mills Mall Dental, PA

Organization General Practice Dentistry · NPI 1306088133

Sawgrass Mills Mall Dental, PA is a General Practice Dentistry in Sunrise, Florida. Registered with an NPI since 2009.

In the registry since
2009
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

165 NW 136th Ave #C110
Sunrise, FL 33325-2624
Phone: (954) 846-7171
Fax: (954) 846-7170
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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 number1306088133
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rostislav Krasnov — Owner · (954) 846-7171
NPI enumeratedMarch 25, 2009
Last updated in NPPESJuly 17, 2024
Certification dateJuly 17, 2024
Mailing address165 Nw 136th Ave, C110, Sunrise, FL 33325-2624

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