Professional Dental Alliance of West Kendall, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF WEST KENDALL, PLLC

Practice address

16371 SW 88TH St
Miami, FL 33196-4942

Phone

(305) 459-3192

NPI assigned

Aug 26, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lauren Howard

Title

Credentialing Specialist

Phone

(757) 576-5479

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1033766944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16371 SW 88TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331964942",
            "telephone_number": "305-459-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF WEST KENDALL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-576-5479"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Group Care Inc.
• Professional Healhcare Management Group, LLC

• General Practice Dentistry in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.