Provider Demographics
NPI:1811874589
Name:BRISA DENTAL ARTS, PLLC
Entity type:Organization
Organization Name:BRISA DENTAL ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JEANINE
Authorized Official - Last Name:SANTIAGO TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-668-3359
Mailing Address - Street 1:2705 SIMPSON RD UNIT 101-103
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4698
Mailing Address - Country:US
Mailing Address - Phone:954-668-3359
Mailing Address - Fax:
Practice Address - Street 1:2705 SIMPSON RD UNIT 101-103
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4698
Practice Address - Country:US
Practice Address - Phone:954-668-3359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-16
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty