Organization Active NPI

Shiny Smile Dental Care

  • Dentist
  • Opa Locka, FL
National Provider Identifier
1053557363
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15967 Issued in FL
Legal business name
SHINY SMILE DENTAL CARE
Practice address
482 Fisherman St
Opa Locka, FL 33054-3818
Phone
(305) 687-6880
Fax
(305) 688-1661
NPI assigned
Dec 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Authorized official

Name
Dr. Mayra Fandino, DDS
Title
Dentist
Phone
(305) 687-6880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN15967 FL Primary

Addresses

Primary practice location

482 Fisherman St
Opa Locka, FL 33054-3818

Mailing address

482 Fisherman St
Opa Locka, FL 33054-3818
Phone (305) 687-6880

National Provider Directory

National Provider Directory

Locations

482 Fisherman St
Opa Locka, FL 33054
Phone (305) 687-6880

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1053557363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 FISHERMAN ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543818",
            "telephone_number": "305-687-6880",
            "fax_number": "305-688-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 FISHERMAN ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543818",
            "telephone_number": "305-687-6880",
            "fax_number": "305-688-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINY SMILE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "FANDINO",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "305-687-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opa Locka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; 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.