Mta Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17962 Issued in FL

Legal business name

MTA DENTAL LLC

Doing business as

Alpha Dental Practice

Practice address

6268 W Sample Rd
Unit 401
Coral Springs, FL 33067-3272

Phone

(305) 484-7879

NPI assigned

Jun 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Maya Georges Assi, DMD

Title

President

Phone

(305) 484-7879

Specialties & licenses 1

Addresses

Other names 1

• Alpha Dental Practice Doing business as

Locations

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1043505068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6268 W SAMPLE RD",
            "address_2": "UNIT 401",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330673272",
            "telephone_number": "305-484-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6268 W SAMPLE RD",
            "address_2": "UNIT 401",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330673272",
            "telephone_number": "305-484-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "GEORGES ASSI",
        "authorized_official_first_name": "MAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-484-7879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Coral Springs, FL
• Providers in Coral Springs, 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 Jun 17, 2011; 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.