Provider Demographics
NPI:1144637133
Name:DIMITRIU, SORIN (DDS)
Entity type:Individual
Prefix:
First Name:SORIN
Middle Name:
Last Name:DIMITRIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E HILLSBORO BLVD
Mailing Address - Street 2:#208
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4355
Mailing Address - Country:US
Mailing Address - Phone:954-420-0551
Mailing Address - Fax:
Practice Address - Street 1:1500 E HILLSBORO BLVD
Practice Address - Street 2:208
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4355
Practice Address - Country:US
Practice Address - Phone:954-673-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN119611223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health