Live Implants Corp

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

LIVE IMPLANTS CORP

Practice address

18001 Old Cutler Rd Ste 405
Palmetto Bay, FL 33157-6434

Phone

(786) 249-4514

NPI assigned

Jul 2, 2021

Organization subpart

No

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

Authorized official

Name

Virgilio J Mongalo, DMD

Title

Doctor

Phone

(786) 249-4514

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625184000000",
    "number": "1033780895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 OLD CUTLER RD STE 405",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331576434",
            "telephone_number": "786-249-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 OLD CUTLER RD STE 405",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331576434",
            "telephone_number": "786-249-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE IMPLANTS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A",
        "authorized_official_last_name": "MONGALO",
        "authorized_official_first_name": "VIRGILIO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "786-249-4514",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Giovanna Llanes, RN
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• Alejandra Llano, DMD
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• Oral and Maxillofacial Surgery Clinic/Center in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.