NPIMap

Organization Active NPI

American Pediatric Dental Doral, Inc

Doing business as American Pediatric Dental Group

  • Pediatric Dentistry
  • Doral, FL
National Provider Identifier
1063816122
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN17608 Issued in FL
Legal business name
AMERICAN PEDIATRIC DENTAL DORAL, INC
Doing business as
American Pediatric Dental Group
Practice address
7950 NW 53Rd St
Suite 200
Doral, FL 33166-4653
Phone
(305) 407-2134
NPI assigned
Oct 20, 2014
Last updated
Oct 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Dr. William Antonio Pena, DMD, MS, MBANPI 1922246388
Title
President
Phone
(305) 407-2134

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN17608 FL Primary

Addresses

Primary practice location

7950 NW 53Rd St
Suite 200
Doral, FL 33166-4653

Mailing address

7950 NW 53Rd St
Suite 200
Doral, FL 33166-4653
Phone (305) 407-2134

Other identifiers 1

IdentifierTypeStateIssuer
000641100MedicaidFL

Other names 1

  • American Pediatric Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

7950 NW 53rd St
Ste 200
Miami, FL 33166
Phone (305) 407-2134

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1063816122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 NW 53RD ST",
            "address_2": "SUITE 200",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331664653",
            "telephone_number": "305-407-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 NW 53RD ST",
            "address_2": "SUITE 200",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331664653",
            "telephone_number": "305-407-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN PEDIATRIC DENTAL DORAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-407-2134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS, MBA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000641100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Pediatric Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.