Main Street Children'S Dentistry of Miami Lakes, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY OF MIAMI LAKES, PLLC

Practice address

15501 NW 67TH Ave Ste 201
Miami Lakes, FL 33014-2108

Phone

(786) 577-4968

NPI assigned

Sep 11, 2014

Organization subpart

No

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

Authorized official

Name

Stephanie Gomez

Title

Provider Relations

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald Alfred Gallo, DMD

  • General Practice Dentistry
  • Miami Lakes, FL
  • NPI 1831109487
  NPD (past)

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1043611858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15501 NW 67TH AVE STE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15501 NW 67TH AVE STE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142108",
            "telephone_number": "786-577-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY OF MIAMI LAKES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magic World Transport LLC
• Magna Physical Therapy, LLC
• Sharon Mahabir
• David CHI Mai, D.P.M.
• Maidelys Oliva DMD PA
• Main Street Orthodontics of Miami Lakes, P.a.
• Main Street Orthodontics of Miami Lakes, PA
• Maju'S Home Care, Inc.
• Yusnely Makence Letts
• Daniella J Maldonado-Ortega

• Pediatric Dentistry in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.