MDR Dental Corp.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MDR DENTAL CORP.

Practice address

10543 SW 109TH CT
Miami, FL 33176-3308

Phone

(305) 595-0917

Fax

(305) 595-0919

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Carlos E Diaz, CEO

Title

Owner

Phone

(786) 669-9755

Specialties & licenses 1

Addresses

Other names 1

• MDR Dental Corp. Former legal business name

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1043998974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10543 SW 109TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10543 SW 109TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763308",
            "telephone_number": "305-595-0917",
            "fax_number": "305-595-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDR DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-669-9755",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDR Dental Corp.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.