NPIMap

Organization Active NPI

Gateway Dental Inc

  • Dentist
  • Miami Gardens, FL
National Provider Identifier
1063869774
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15212 Issued in FL
Legal business name
GATEWAY DENTAL INC
Practice address
1440 NE Miami Gardens Drive
Suite 201
Miami Gardens, FL 33179
Phone
(305) 856-2300
Fax
(305) 856-0921
NPI assigned
May 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Dr. Pablo Miranda, DMD
Title
Owner
Phone
(305) 856-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN15212 FL Primary

Addresses

Primary practice location

1440 NE Miami Gardens Drive
Suite 201
Miami Gardens, FL 33179

Mailing address

1440 NE Miami Gardens Drive
Miami Gardens, FL 33179
Phone (305) 856-2300

Other identifiers 1

IdentifierTypeStateIssuer
101379500MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Gateway Dental Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1440 NE Miami GDNS Dr
Miami Gardens, FL 33179

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1063869774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 NE MIAMI GARDENS DRIVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "33179",
            "telephone_number": "305-856-2300",
            "fax_number": "305-856-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 NE MIAMI GARDENS DRIVE",
            "address_2": "SUITE 201",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "33179",
            "telephone_number": "305-856-2300",
            "fax_number": "305-856-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-23",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "PABLO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-856-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101379500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.