FLORIDA MEDICAID ADULT PROVIDER DIRECTORY ... - LIBERTY Dental Plan

[Pages:109]FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

ALACHUA COUNTY

DENTIST

# RHC010936

Acorn Clinic

23320 N State Road 235 Brooker, FL 32622

(352) 485-2772 Special Needs: Yes English, Spanish, Gujarati M-T 8am - 3:30 pm # DN18987 Bhakta, Paayal

NPI: 1033439823 LIC: DN18987 # DN9374 Hsiung, Edwin

NPI: 1417389586 LIC: DN9374 # DN21295 Luaces, Olga

NPI: 1407237555 LIC: DN21295

# 010980

Affordable Dentures Gainesville, P.A.

9200 Nw 39Th Ave, Ste 200 Gainesville, FL 32606

(352) 376-8229 Special Needs: Yes English M-T 7:45 am - 3pm W-F 7:45 am - 3pm # DN6996 Showstark, Stephan

NPI: 1639266562 LIC: DN6996

# EV1081165

Agency for Person's with Disabilities - Tacachale

1621 Ne Waldo Road Gainesville, FL 32609

(352) 955-5665 Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm

# DN8807 Garvey, Timothy* NPI: 1205892296 LIC: DN8807

# FQHC010440

Aza Health

410 Ne Waldo Rd Gainesville, FL 32641

(352) 375-3790 Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm # DN15770 Halady, Pratima

General Dentist servicing as: Pediatric Dentistry NPI: 1720256811 LIC: DN15770

# DN25141FL Le, Lynn NPI: 1336750470 LIC: DN25141FL

# DN20873 Lopez, Melvin General Dentist servicing as: Pediatric Dentistry NPI: 1689081242 LIC: DN20873

# DN16033FL Nguyen, Daniel NPI: 1134238892 LIC: DN16033FL

# DN20946FL Nguyen, David NPI: 1811398423 LIC: DN20946FL

# DN12941 Pairot, Alfredo General Dentist servicing as: Pediatric Dentistry NPI: 1932174448 LIC: DN12941

# DN20886 Wells, Rachelle General Dentist servicing as: Pediatric Dentistry NPI: 1588858286 LIC: DN20886

CERTIFICATIONS: ? Inhalation Sedation

# CHC014623

DOH - Alachua County Health Department

816 Sw 64Th Terrance Gainesville, FL 32607

(352) 334-8839 Special Needs: Yes English, Russian, Bulgarian, German, Italian, Spanish M-T 8am - 5pm W-F 8am - 5pm

# DTC37 Silva Bonar, Jose* NPI: 1215944707 LIC: DTC37

# DN21933 Vu, Clara* General Dentist servicing as: Pediatric Dentistry NPI: 1235589482 LIC: DN21933

CERTIFICATIONS: ? Inhalation Sedation

# CHC017031

DOH - Alachua County Health Department

224 Se 24 St Gainesville, FL 32641

(352) 334-8839 Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm

# DTC37 Silva Bonar, Jose* NPI: 1215944707 LIC: DTC37

# DN21933 Vu, Clara* General Dentist servicing as: Pediatric Dentistry NPI: 1235589482 LIC: DN21933

CERTIFICATIONS: ? Inhalation Sedation

# 010934

Edwin F. Johary, DDS

1831 Nw 13Th Street, Ste #4 Gainesville, FL 32609

(352) 377-0360 Special Needs: Yes English, Spanish W-F 9am - 5pm

# DN15990 Johary, Edwin*

NPI: 1609916899 LIC: DN15990 CERTIFICATIONS:

? Inhalation Sedation

# 011246

Gainesville Dental Center

4000 West Newberry Road, Ste E Gainesville, FL 32607

(352) 378-3131 Special Needs: Yes English, Arabic M-T 9am - 5pm # DN9531 Attia, Safwat*

NPI: 1952311730 LIC: DN9531

# 010755

University of Florida College of Dentistry

1600 Sw Archer Rd Gainesville, FL 32610 dental.ufl.edu

(352) 273-6701 Special Needs: Yes English, Other M-T 8am - 5pm W-F 8am - 5pm # DTP749 Alhilou, Ahmed

NPI: 1497411128 LIC: DTP749 # DN14714 Barnes, David

NPI: 1467667451 LIC: DN14714 # DN24628FL Bauman, Eric

NPI: 1114017209 LIC: DN24628FL # DN7077 Benjamin, Paul

NPI: 1225057128 LIC: DN7077 # DN16284 Borders, Kelley

NPI: 1043355522 LIC: DN16284 # DN8382 Cook, Larry

NPI: 1902813777 LIC: DN8382 # DN20352FL Corasro, Andrew

NPI: 1144656232 LIC: DN20352FL

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 1 of 109

07/03/2023 v2(2020)

FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

# DTP743 Daher Achi, Astrid NPI: 1053870931 LIC: DTP743

# DTP603 Delgado, Alejandro NPI: 1669887485 LIC: DTP603

# DTP747 Denton, Scott NPI: 1740389147 LIC: DTP747

# DTP639 Dias Ribeiro, Ana NPI: 1053860924 LIC: DTP639

# DN13471 Dilbone, Deborah NPI: 1104882497 LIC: DN13471

# DN21973 Fields, Kyle NPI: 1871048157 LIC: DN21973

# DN8807 Garvey, Timothy NPI: 1205892296 LIC: DN8807

# DTP710 Gohel, Rajendra NPI: 1912071754 LIC: DTP710

# DN7710 Haddix, James NPI: 1336105709 LIC: DN7710

# DTP672 Haddock, Fernando NPI: 1477531234 LIC: DTP672

# DTP731 Hosney, Sherif NPI: 1215515515 LIC: DTP731

# DN9870 Kaleel, Nicholas NPI: 1447258991 LIC: DN9870

# DTP746 Kouveliotis, Georgios NPI: 1457023996 LIC: DTP746

# DN21295 Luaces, Olga NPI: 1407237555 LIC: DN21295

# DTP659 Migliorati, Cesar General Dentist servicing as: Endodontics NPI: 1992810519 LIC: DTP659

CERTIFICATIONS: ? Inhalation Sedation

# DTP497 Nascimento, Marcelle NPI: 1275706426 LIC: DTP497

# DTP702 Oliveira, Dayane NPI: 1487204178 LIC: DTP702

# DN16197 Orlando, Joseph NPI: 1326176389 LIC: DN16197

# DN8944 Ottenga, Marc NPI: 1306802293 LIC: DN8944

CERTIFICATIONS: ? Inhalation Sedation

# DTP612 Pereira, Patricia NPI: 1437535218 LIC: DTP612

NPI: 1356393821 LIC: DTP450 CERTIFICATIONS:

? Inhalation Sedation ? Board Certification

# DTP748 Soares Leibovitch, Indala

NPI: 1770245011 LIC: DTP748

ORAL SURGEON

# DN21168 Pocola, Eduard

# DTP232 Dolwick, Melvin

NPI: 1134510068 LIC: DN21168

NPI: 1659337590 LIC: DTP232

# DTP683 Reis, Andre NPI: 1891278768 LIC: DTP683

# DN14930 Rey, Rosalia NPI: 1346341443 LIC: DN14930

CERTIFICATIONS: ? Inhalation Sedation ? Board Certification

# DTP664 Freburg-Hoffmeister, Danielle

# DTP490 Ribeiro-DaSilva,

NPI: 1447545132 LIC: DTP664

Margarete

CERTIFICATIONS:

NPI: 1326228321 LIC: DTP490

? Inhalation Sedation

# DTP703 Rocha, Mateus NPI: 1376193060 LIC: DTP703

# DTP709 Gohel, Anita NPI: 1841563947 LIC: DTP709

# DTP562 Roulet, Jean-Francois NPI: 1831539816 LIC: DTP562

# DN24076 Savioli, Cynthia NPI: 1336677756 LIC: DN24076

# DTP669 Sikand, Rebecca NPI: 1942654546 LIC: DTP669

# DTP645 Silva, Maria NPI: 1932452547 LIC: DTP645

# DN22024 Terza, Stephanni NPI: 1588014591 LIC: DN22024

ENDODONTICS

# DN12910 Hardeman, John NPI: 1447343918 LIC: DN12910

CERTIFICATIONS: ? Inhalation Sedation ? General Anesthesia ? Board Certification

# DN25920FL Holley, Tyler NPI: 1154760411 LIC: DN25920FL

# DTP761 Nessif, Richard NPI: 1497086342 LIC: DTP761

# DTP741FL Pahadia, Mayank NPI: 1861065948 LIC: DTP741FL

# DTP718 Vyas, Rutvi

# DTP654 Bakiri, Eleonora

NPI: 1487252573 LIC: DTP718

NPI: 1952834418 LIC: DTP654

# DN14544 Cerrud, Clinio NPI: 1629184676 LIC: DN14544

CERTIFICATIONS: ? Inhalation Sedation

# DTP450 Pileggi, Roberta

PEDIATRIC DENTISTRY

# DTP437 Adewumi, Abimbola NPI: 1285690636 LIC: DTP437

CERTIFICATIONS: ? Inhalation Sedation ? Board Certification

# DTP720 Carey, Teemar* NPI: 1538549951 LIC: DTP720

# DN22995 Connell, Christopher* NPI: 1689125742 LIC: DN22995

CERTIFICATIONS: ? Inhalation Sedation

# DTP418 Guelmann, Marcio* NPI: 1972568848 LIC: DTP418

CERTIFICATIONS: ? Inhalation Sedation ? Board Certification

# DN18234 Perez, Edna* NPI: 1962536714 LIC: DN18234

CERTIFICATIONS: ? Inhalation Sedation ? Board Certification

PERIODONTICS

# DTP606 Chang, Jia NPI: 1871862029 LIC: DTP606

# DTP687 Duarte Reis, Poliana NPI: 1619448677 LIC: DTP687

# DTP638 Duarte, Wagner NPI: 1407305022 LIC: DTP638

# DN21876 Schey, Karin NPI: 1285086173 LIC: DN21876

PROSTHODONTICS

# DTP784 Abdulhameed, Nader NPI: 1457701914 LIC: DTP784

# DTP756 Albuquerque Garcia, Bruna

NPI: 1326780396 LIC: DTP756 # DTP722FL Cabrera da Silva, Alexandre

NPI: 1962004408 LIC: DTP722FL # DTP467 Esquivel-Upshaw, Josephine

NPI: 1760495527 LIC: DTP467 # DTP653 Zoidis, Panagiotis

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 2 of 109

07/03/2023 v2(2020)

FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

NPI: 1871020495 LIC: DTP653

BAY COUNTY

DENTIST

# 010672

Eric R. Claussen D.M.D., P.A.

2624 Jenks Ave Panama City, FL 32405

(850) 215-0798 Special Needs: Yes English M-T 8am - 4pm W-F 8am - 4pm # DN17200 Fleigel III, Jeffrey*

NPI: 1336357748 LIC: DN17200 CERTIFICATIONS:

? Board Certification

# FQHC010683

PanCare of Florida, Inc.

403 E. 11Th St Panama City, FL 32401

(850) 767-3350 Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm # DN10365FL Barry, Steven

NPI: 1497826531 LIC: DN10365FL # DN19128 Claussen, Meghann

NPI: 1336454651 LIC: DN19128 # DN25097 Haynam, Eric

NPI: 1043688831 LIC: DN25097 # DN18668 Isaac, Kanyaratana

NPI: 1003122656 LIC: DN18668 # DN21740 Moffa, Michelle

General Dentist servicing as: NPI: 1841277407 LIC: DN21740

# DN19745 Norton, Andrew NPI: 1861754020 LIC: DN19745

# DN18871 Pate, Sheena General Dentist servicing as: NPI: 1215255880 LIC: DN18871

# DN21660 Piorkowski, Gary General Dentist servicing as: NPI: 1699705434 LIC: DN21660

# DN23084 Santos, Iris NPI: 1487875233 LIC: DN23084

# HAD69 Smith, Amy NPI: 1831209899 LIC: HAD69

# HAD65 Wilhite, Rhonda General Dentist servicing as: NPI: 1952496341 LIC: HAD65

# FQHC022012

PanCare of Florida, Inc.

12427 Hwy 231 Youngstown, FL 32466

(850) 753-3246 Special Needs: Yes English M-T 8am - 5pm W-F 8am - 5pm # DN10365FL Barry, Steven

NPI: 1497826531 LIC: DN10365FL # DN19128 Claussen, Meghann

NPI: 1336454651 LIC: DN19128 # DN25097 Haynam, Eric

NPI: 1043688831 LIC: DN25097 # DN21740 Moffa, Michelle

General Dentist servicing as: NPI: 1841277407 LIC: DN21740 # DN19745 Norton, Andrew NPI: 1861754020 LIC: DN19745 # DN18871 Pate, Sheena General Dentist servicing as:

NPI: 1215255880 LIC: DN18871 # DN23084 Santos, Iris

NPI: 1487875233 LIC: DN23084 # HAD69 Smith, Amy

NPI: 1831209899 LIC: HAD69 # HAD65 Wilhite, Rhonda

General Dentist servicing as: NPI: 1952496341 LIC: HAD65

ORAL SURGEON

# 010672

Eric R. Claussen D.M.D., P.A.

2624 Jenks Ave Panama City, FL 32405

(850) 215-0798 Special Needs: Yes English M-T 8am - 4pm W-F 8am - 4pm # DN24725 Brinker, Matthew*

NPI: 1033567367 LIC: DN24725 # DN17080 Claussen, Eric

NPI: 1194983965 LIC: DN17080 CERTIFICATIONS:

? Inhalation Sedation ? General Anesthesia

# DN23806 Long, Larry NPI: 1275527137 LIC: DN23806

BREVARD COUNTY

DENTIST

M-T 8am - 6pm W-Th 8am - 6pm

# HAD82 Alongi, Jennifer* General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82

CERTIFICATIONS: ? Inhalation Sedation

# DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021

CERTIFICATIONS: ? Inhalation Sedation

# HAD118 Fife, John* NPI: 1609427947 LIC: HAD118

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD16 Kormann, Jacqueline* General Dentist servicing as: Pediatric Dentistry NPI: 1346214889 LIC: HAD16

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC011681

Brevard Health Alliance

2120 Sarno Rd Melbourne, FL 32935

(321) 241-6800 Special Needs: Yes English, Spanish

# FQHC011682

Brevard Health Alliance

220 Barton Blvd, Unit C14 Rockledge, FL 32955

(321) 639-5177 Special Needs: Yes

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 3 of 109

07/03/2023 v2(2020)

FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

English, Spanish M-T 8am - 6pm W-Th 8am - 6pm # HAD82 Alongi, Jennifer*

General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82 CERTIFICATIONS: ? Inhalation Sedation # DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021

CERTIFICATIONS: ? Inhalation Sedation

# HAD118 Fife, John* NPI: 1609427947 LIC: HAD118

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD16 Kormann, Jacqueline* General Dentist servicing as: Pediatric Dentistry NPI: 1346214889 LIC: HAD16

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC016241

Brevard Health Alliance

7227 N. Us Hwy 1 Cocoa, FL 32927

(321) 877-2740 Special Needs: Yes

English, Spanish M-T 8am - 6pm W-Th 8am - 6pm # HAD82 Alongi, Jennifer*

General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82 CERTIFICATIONS: ? Inhalation Sedation # DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021

CERTIFICATIONS: ? Inhalation Sedation

# HAD118 Fife, John* NPI: 1609427947 LIC: HAD118

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD16 Kormann, Jacqueline* General Dentist servicing as: Pediatric Dentistry NPI: 1346214889 LIC: HAD16

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC021352

Brevard Health Alliance

5270 Babcock Street Ne Ste #1 Palm Bay, FL 32905

(321) 722-5959 Special Needs: Yes

Spanish, English M-T 8am - 6pm W-Th 8am - 6pm # HAD82 Alongi, Jennifer*

General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82 CERTIFICATIONS: ? Inhalation Sedation # DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021

CERTIFICATIONS: ? Inhalation Sedation

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC021353

Brevard Health Alliance

775 Malabar Road Ste #105 Malabar, FL 32950

(321) 733-0642 Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm # HAD82 Alongi, Jennifer*

General Dentist servicing as: Pediatric Dentistry

NPI: 1306139019 LIC: HAD82 CERTIFICATIONS:

? Inhalation Sedation

# DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021

CERTIFICATIONS: ? Inhalation Sedation

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC021354

Brevard Health Alliance

1537 N Singleton Ave Titusville, FL 32796

(321) 268-0267 Special Needs: Yes English M-T 8am - 6pm W-Th 8am - 6pm # HAD82 Alongi, Jennifer*

General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82 CERTIFICATIONS: ? Inhalation Sedation # DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory*

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 4 of 109

07/03/2023 v2(2020)

FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021 CERTIFICATIONS: ? Inhalation Sedation # DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD16 Kormann, Jacqueline* General Dentist servicing as: Pediatric Dentistry NPI: 1346214889 LIC: HAD16

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC021355

Brevard Health Alliance

17 Silver Palm Ave Melbourne, FL 32901

(321) 733-2021 Special Needs: Yes English, Chinese Mandarin, Spanish M-T 8am - 6pm W-Th 8am - 6pm

# HAD82 Alongi, Jennifer* General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82

CERTIFICATIONS: ? Inhalation Sedation

# DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry

NPI: 1952303059 LIC: DN14021 CERTIFICATIONS:

? Inhalation Sedation

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

# FQHC2311508

Brevard Health Alliance University Dental

601 E University Blvd Melbourne, FL 32901

(321) 241-6800 Special Needs: No English, Spanish M-T 8am - 5pm W-F 8am - 5pm

# HAD82 Alongi, Jennifer* General Dentist servicing as: Pediatric Dentistry NPI: 1306139019 LIC: HAD82

CERTIFICATIONS: ? Inhalation Sedation

# DN22332 Baddour, Mary* NPI: 1730630633 LIC: DN22332

# DN14021 Cheshire, Gregory* General Dentist servicing as: Pediatric Dentistry NPI: 1952303059 LIC: DN14021

CERTIFICATIONS: ? Inhalation Sedation

# DN25385 Hicks, Michael* NPI: 1407347107 LIC: DN25385

# HAD16 Kormann, Jacqueline* General Dentist servicing as: Pediatric Dentistry NPI: 1346214889 LIC: HAD16

# HAD116 Mintz, Talya* NPI: 1255418588 LIC: HAD116

# DN20658 Smith, Ross* General Dentist servicing as: Pediatric Dentistry NPI: 1245626811 LIC: DN20658

CERTIFICATIONS: ? Inhalation Sedation

# DN25324 Wilson, Shayla* NPI: 1689239691 LIC: DN25324

NPI: 1396969507 LIC: DN16620

# EV1079996

Allure Dental of Hollywood

8580 Stirling Rd Ste 101 Hollywood, FL 33024

(954) 500-0102 Special Needs: Yes English, Russian, French, Portuguese, Spanish M-T 9am - 5pm W-F 9am - 5pm # DN26161 Azbel, Aleksandr

NPI: 1699829291 LIC: DN26161

BROWARD COUNTY DENTIST

# DN26139FL Kisanova Lipkin, Dina

NPI: 1598336117 LIC: DN26139FL

# 013157

All Care Dental

3207 North State Road 7, Ste 24 Margate, FL 33063

(954) 979-1357 Special Needs: No English, Spanish, Portuguese W-F 9am - 5pm

# DN23936 Hernandez-Acevedo, Sugeily

General Dentist servicing as: Endodontics NPI: 1780123851 LIC: DN23936

# DN22957FL Ortiz Javier, Alexandra

General Dentist servicing as: Endodontics NPI: 1104340322 LIC: DN22957FL

# DN19530 Swanson, Wendy NPI: 1790085819 LIC: DN19530

# DN16620 Yeoshoua, Oded

# DN23637 Lopez, Catherine NPI: 1558841890 LIC: DN23637

# DN17761 Valdman, Vadim NPI: 1184860413 LIC: DN17761

CERTIFICATIONS: ? Inhalation Sedation

# 022277

Allure Dental of Plantation PLLC

1945 N Pine Island Rd Fort Lauderdale, FL 33322

(954) 473-9161 Special Needs: Yes English, Russian, Spanish M 9am - 5pm, T 10am - 6pm W-Th 9am - 5pm # DN26161 Azbel, Aleksandr

NPI: 1699829291 LIC: DN26161

# DN24891 Calderon, Kelly NPI: 1306463344 LIC: DN24891

# DN26139FL Kisanova Lipkin, Dina

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

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FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

NPI: 1598336117 LIC: DN26139FL

# DN20696 Kopynets, Viktor General Dentist servicing as: Pediatric Dentistry NPI: 1932517042 LIC: DN20696

CERTIFICATIONS: ? Inhalation Sedation

# DN23637 Lopez, Catherine NPI: 1558841890 LIC: DN23637

# DN17761 Valdman, Vadim NPI: 1184860413 LIC: DN17761

CERTIFICATIONS: ? Inhalation Sedation

# 016880

Allure Dental PLLC

4267 W Commerical Blvd Tamarac, FL 33319

(954) 677-3202 Special Needs: Yes English, Russian, French, Spanish M-T 9am - 5pm W-F 9am - 5pm # DN26161 Azbel, Aleksandr

NPI: 1699829291 LIC: DN26161

# DN24891 Calderon, Kelly NPI: 1306463344 LIC: DN24891

# DN26139FL Kisanova Lipkin, Dina

NPI: 1598336117 LIC: DN26139FL

# DN20696 Kopynets, Viktor General Dentist servicing as: Pediatric Dentistry NPI: 1932517042 LIC: DN20696

CERTIFICATIONS: ? Inhalation Sedation

# DN17761 Valdman, Vadim NPI: 1184860413 LIC: DN17761

CERTIFICATIONS: ? Inhalation Sedation

# 008282

Andrew Dental Care Center, PA

3909 N Andrews Ave Oakland Park, FL 33309 andrewsdentalcarecenter.n et

(954) 561-6675 Special Needs: Yes English, Spanish, Haitian; Haitian Creole W-F 9am - 5pm

# DN17611 Riley, Marilyn*

NPI: 1114941614 LIC: DN17611

# EV789891

Broward Health

200 Nw 7Th Ave Fort Lauderdale, FL 33311

(954) 759-6710 Special Needs: Yes English, Spanish M-T 8am - 4:30 pm # DN22922 Oliveira, Paulo

NPI: 1285157826 LIC: DN22922

# DN22126 Pham, Christopher NPI: 1720431133 LIC: DN22126

# 020606

Bright Smiles of Sunrise

# 006578

10108 W Oakland Park Blvd.

Broward Mall Dental

Sunrise, FL 33351

8000 W Broward Blvd Ste 1123

Plantation, FL 33388

(954) 900-2059



Special Needs: No

(954) 476-0802

English, Spanish

Special Needs: Yes

M 10am - 7pm, T 9am - 5pm

English, Arabic, French, Russian,

Slavic(other), Spanish

# DN21846 Fonseca, Jacqueline* M-T 10am - 6pm

NPI: 1487005369 LIC: DN21846

W-F 10am - 6pm

# FQHC020446

Broward Community & Family Health Centers, Inc

162 N. Powerline Rd. Pompano Beach, FL 33069

(954) 970-7067 Special Needs: Yes English, Spanish, Creoles and Pidgins (other), French M 8:30 am - 5pm, T 10am - 7pm W-F 8:30 am - 5pm

# DN24341 Salas, Julio NPI: 1427619253 LIC: DN24341

# DN21962 Trenkova, Violeta NPI: 1841641792 LIC: DN21962

# DN22246 Antezana, Mauricio General Dentist servicing as: Pediatric Dentistry NPI: 1063876399 LIC: DN22246

# DN21079 Arnedo, Johanna General Dentist servicing as: Pediatric Dentistry NPI: 1104213909 LIC: DN21079

CERTIFICATIONS: ? Inhalation Sedation

# DN17412 Atkinson, William General Dentist servicing as: Pediatric Dentistry NPI: 1942360862 LIC: DN17412

CERTIFICATIONS: ? Inhalation Sedation

# DN17123 Bravo, Raquel

NPI: 1538312525 LIC: DN17123

# DN20945 Fornos, Jorge NPI: 1831594415 LIC: DN20945

# DN25463 Garcia, Angela NPI: 1013466424 LIC: DN25463

# DN24357FL George, Kiren NPI: 1225690829 LIC: DN24357FL

# DN20710 Gonzalez, Kely NPI: 1952717027 LIC: DN20710

# DN23004 Gonzalez-Diaz, Ernesto

NPI: 1619360716 LIC: DN23004 # DN17335FL Guilarte, Rhona

NPI: 1619956323 LIC: DN17335FL # DN27207 Hernandez, Lisandra

NPI: 1679200653 LIC: DN27207 # DN25395FL Khan, Muhammad

NPI: 1063023703 LIC: DN25395FL # DN26151 Khan, Omair

General Dentist servicing as: Endodontics NPI: 1609449628 LIC: DN26151 # DN25619 Knafo, Esther NPI: 1811519648 LIC: DN25619 # DN16377 Krasnov, Rostislav NPI: 1942267935 LIC: DN16377 # DN20101 Licina, Zeljka NPI: 1013263292 LIC: DN20101 # DN27222 Mohammed, Hajir NPI: 1033844345 LIC: DN27222 # 24529 Moini, Marshall NPI: 1437700937 LIC: 24529 # DN27354 Oliva, Luis NPI: 1710614409 LIC: DN27354 # DN20909 Ospina, Carolina General Dentist servicing as: Oral Surgery NPI: 1467853085 LIC: DN20909

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 6 of 109

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FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

# DN26900 Ramos Navarro, Roger

NPI: 1154051563 LIC: DN26900 # DN13564 Rayan, Khalid

NPI: 1750543617 LIC: DN13564 # DN18624 Rey, Yanet

NPI: 1174751176 LIC: DN18624 # DN19552 Schot, Raquel

NPI: 1467737734 LIC: DN19552 # DN25721 Shinder, Arthur

NPI: 1588276257 LIC: DN25721 # DN13621 Tiwary, Alka

NPI: 1669751871 LIC: DN19522 # DN21495 Streett, Rosario

NPI: 1801230768 LIC: DN21495 # DN23764 Wilkins, Lorena

NPI: 1669950192 LIC: DN23764

# EV2573339

Comfy Smile Dental

11356 W State Road 84 Fort Lauderdale, FL 33325

(954) 251-0804 Special Needs: No English, Spanish

# 013315

David Eugene, DDS, PLLC

2447 North State Road 7 Fort Lauderdale, FL 33313

(954) 733-9971 Special Needs: Yes French, English, Creoles and Pidgins French-based(other) M-T 9am - 4pm W-Th 9am - 4pm

# DN18594 Eugene, David NPI: 1306080304 LIC: DN18594

NPI: 1154511681 LIC: DN13621

M-T 9am - 5pm

# 016631

# DN26517 Torres, Yusleimys

W-Th 9am - 5pm

Dental Clinique

NPI: 1326600545 LIC: DN26517

# DN21066 Uzunova-Dimova, Kalina

General Dentist servicing as: Pediatric Dentistry NPI: 1245540947 LIC: DN21066

# DN19930 Vazana, Todd NPI: 1710234844 LIC: DN19930

# DN26353 Villavicencio, Yamile

# DN21994 Cortes Morales, Guillermo

NPI: 1912359266 LIC: DN21994 # DN21249 Prieto, Evelyn

NPI: 1598146755 LIC: DN21249

# FQHC014907

Community AIDS Resource, Inc.

871 W. Oakland Park Blvd

16636 Sheridan St Pembroke Pines, FL 33331

(954) 228-6661 Special Needs: Yes English, Spanish, Portuguese M-T 9am - 5:30 pm W-F 9am - 5:30 pm

# DN19055 Segrera, Maria NPI: 1295046662 LIC: DN19055

NPI: 1831652411 LIC: DN26353

Fort Lauderdale, FL 33311

# DN27465 Zaman, Bisma



# EV3183069

NPI: 1497478507 LIC: DN27465

(305) 576-1234

Dentilife Four PA

# DN26855 Zayed, Amani NPI: 1033546395 LIC: DN26855

# EV2346270

Cano Dental

Special Needs: Yes English, Spanish, Creoles and Pidgins French-based(other) M-T 8am - 5:15 pm Th-F 8am - 5:15 pm

# DN13731 Barnes, Curtis

5473 N State Rd 7 Tamarac, FL 33319

(954) 486-7026 Special Needs: No English, Spanish M-T 10am - 3pm

8251 W Broward Blvd Ste 102

NPI: 1689798936 LIC: DN13731

W 10am - 6am, Th 10am - 4pm,

Fort Lauderdale, FL 33324 (786) 605-9242

Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm

# DN18139 Casas, Manuel NPI: 1740420090 LIC: DN18139

F 10am - 3pm # DN19377 Calderon, Erik

# DN9225 Heider, Joseph NPI: 1609879667 LIC: DN9225

NPI: 1942596416 LIC: DN19377 CERTIFICATIONS:

? Inhalation Sedation

# DN26021 Sangiovanni, Gabriela

# DN19522 Hernandez, Stephanie NPI: 1356910863 LIC: DN26021

# EV866681

Dr Quesada & Associates PA

6267 W Sample Rd Pompano Beach, FL 33067

(954) 341-4766 Special Needs: Yes English, Spanish M-T 9am - 4pm # DN21528 Quesada, Pedro*

NPI: 1164898177 LIC: DN21528

# 007554

Dr. Ira Goldman

2100 East Hallendale Beach Blvd, Ste # 409 Hallandale, FL 33009

(954) 456-9844 Special Needs: No English M 9am - 1pm, T 9am - 5pm W-Th 9am - 5pm # DN5717 Goldman, Ira*

NPI: 1326113937 LIC: DN5717

# 019656

Excellent Dental

680 N. University Dr Pembroke Pines, FL 33024

(954) 982-7645 Special Needs: Yes English, Spanish M-T 9am - 5pm W-F 9am - 5pm # DN23321 Aleman, Jose

NPI: 1770061020 LIC: DN23321 # DN15923 Arzola, Vanessa

NPI: 1295816924 LIC: DN15923 # DN21645 Baez Henry, Carlianette

NPI: 1235594961 LIC: DN21645 # DN15630 Cano, Lourdes

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 7 of 109

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FLORIDA MEDICAID ADULT

PROVIDER DIRECTORY / DIRECTORIO DE PROVEEDORES

Member Services / Servicios para miembros : (833) 276-0850

NPI: 1093867947 LIC: DN15630

NPI: 1407948482 LIC: DN11150

NPI: 1508225376 LIC: DN23695

NPI: 1518337468 LIC: DN24650

# DN21572 Carballo, Mauro

# DN24107 Serhan Lopez, Nayef # DN23705 Diaz Valle, Orlando # DN17332 Simon, Gelsys

NPI: 1508200635 LIC: DN21572

NPI: 1184282550 LIC: DN24107

NPI: 1457717290 LIC: DN23705

NPI: 1629154299 LIC: DN17332

# DN23695 Cruz, Yanet

# DN24650 Shenouda, Mary

# DN24672 Ducasse, Graciela # DN21495 Streett, Rosario

NPI: 1508225376 LIC: DN23695

NPI: 1518337468 LIC: DN24650

NPI: 1548691017 LIC: DN24672

NPI: 1801230768 LIC: DN21495

# DN23705 Diaz Valle, Orlando # DN17332 Simon, Gelsys

NPI: 1457717290 LIC: DN23705

NPI: 1629154299 LIC: DN17332

# DN24672 Ducasse, Graciela # DN21495 Streett, Rosario

NPI: 1548691017 LIC: DN24672

NPI: 1801230768 LIC: DN21495

# DN23700 Gonzalez, Carmen # DN23355 Viamonte Montes De

NPI: 1285110718 LIC: DN23700

Oca, Yaritza

# DN23529 Gonzalez, Giovanni

NPI: 1174018626 LIC: DN23355

NPI: 1417436189 LIC: DN23529

# DN24393 Vimo, Belen

# DN19802 Hernandez, David

NPI: 1144879925 LIC: DN24393

NPI: 1245593896 LIC: DN19802

# DN23764 Wilkins, Lorena

# DN19522 Hernandez, Stephanie NPI: 1669950192 LIC: DN23764

NPI: 1669751871 LIC: DN19522

# DN25214 Herrera Rosales, Dayamis

NPI: 1184233587 LIC: DN25214

# DN24103 Lopez Neyra, Arlet NPI: 1730747833 LIC: DN24103

# DN23644 Martinez Morales, Lesner

NPI: 1619453743 LIC: DN23644

# DN21356 Milanes, Christian General Dentist servicing as: Endodontics NPI: 1578947610 LIC: DN21356

# 123709

Excellent Dental

4020 W Hillsboro Blvd Deerfield Beach, FL 33442

(754) 240-4304 Special Needs: Yes English, Spanish, Portuguese M-T 8am - 4pm W-F 8am - 4pm # DN23321 Aleman, Jose

NPI: 1770061020 LIC: DN23321

# DN15923 Arzola, Vanessa

# DN23668 Onate, Mario NPI: 1659721900 LIC: DN23668

# DN22255 Rajschmir, Silvina General Dentist servicing as: Pediatric Dentistry NPI: 1679977896 LIC: DN22255

# DN22999 Reyes, Christina NPI: 1679931000 LIC: DN22999

# DN11150 Reyes, Miguel

NPI: 1295816924 LIC: DN15923 # DN21645 Baez Henry, Carlianette

NPI: 1235594961 LIC: DN21645 # DN15630 Cano, Lourdes

NPI: 1093867947 LIC: DN15630 # DN21572 Carballo, Mauro

NPI: 1508200635 LIC: DN21572 # DN23695 Cruz, Yanet

# DN23700 Gonzalez, Carmen # DN23355 Viamonte Montes De

NPI: 1285110718 LIC: DN23700

Oca, Yaritza

# DN23529 Gonzalez, Giovanni

NPI: 1174018626 LIC: DN23355

NPI: 1417436189 LIC: DN23529

# DN24393 Vimo, Belen

# DN19802 Hernandez, David

NPI: 1144879925 LIC: DN24393

NPI: 1245593896 LIC: DN19802

# DN23764 Wilkins, Lorena

# DN19522 Hernandez, Stephanie NPI: 1669950192 LIC: DN23764

NPI: 1669751871 LIC: DN19522 # DN25214 Herrera Rosales, Dayamis

NPI: 1184233587 LIC: DN25214 # DN24103 Lopez Neyra, Arlet

NPI: 1730747833 LIC: DN24103 # DN23644 Martinez Morales, Lesner

NPI: 1619453743 LIC: DN23644 # DN21356 Milanes, Christian

General Dentist servicing as: Endodontics NPI: 1578947610 LIC: DN21356 # DN23668 Onate, Mario NPI: 1659721900 LIC: DN23668 # DN22255 Rajschmir, Silvina General Dentist servicing as: Pediatric Dentistry NPI: 1679977896 LIC: DN22255 # DN22999 Reyes, Christina NPI: 1679931000 LIC: DN22999 # DN11150 Reyes, Miguel NPI: 1407948482 LIC: DN11150 # DN24107 Serhan Lopez, Nayef NPI: 1184282550 LIC: DN24107 # DN24650 Shenouda, Mary

# EV2654971

Excellent Dental

8199 N University Dr Fort Lauderdale, FL 33321

(954) 787-9735 Special Needs: Yes English, Spanish M-T 8am - 5pm W-F 8am - 5pm # DN23764 Wilkins, Lorena

NPI: 1669950192 LIC: DN23764

# 020227

Family Dental Associates PA

6130 W Atlantic Blvd Ste 4 Margate, FL 33063 (954) 973-0990 Special Needs: Yes English, Spanish, Creoles and Pidgins (other) M-T 8am - 5pm W-F 8am - 5pm # DN17643 Blackmore, Sofia

NPI: 1427387687 LIC: DN17643

# DN12687FL Fahey, Dana NPI: 1265617617 LIC: DN12687FL

# DN19201 Mingel, Marc

LIBERTY Dental Plan network provider rating is based on quality measures and service. Overall ratings range from 1 star to 5 stars, with the more stars shows higher quality.

The provider directory is subject to change without notice. Languages spoken by the offices are reported. The languages are not verified by LIBERTY Dental Plan. If you need to access LIBERTY's free interpretation services please call the number listed on your ID card.

To view current providers, please visit our website, FLMedicaid.

El directorio de proveedores est? sujeto a cambios sin previo aviso. Los idiomas que se hablan en las oficinas seran reportados. Los idiomas no son verificados por LIBERTY Dental Plan. Si necesita usar los servicios gratuitos de interpretaci?n de LIBERTY, llame al n?mero que aparece en su tarjeta de identificaci?n.

Para ver los proveedores actuales, visite nuestro sitio web, FLMedicaid.

July, 2023

* Closed to new members / Cerrado para nuevos miembros.

Wheelchair access / Acceso para personas en silla de ruedas.

Weekend and Holiday availability by appointment only / Disponibilidad de fines de semana y d?as festivos solo con cita previa.

Page 8 of 109

07/03/2023 v2(2020)

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