NPIMap

Organization Active NPI

Pediatric Dental Center of Gardens Inc

  • Pediatric Dentistry
  • Miami Gardens, FL
National Provider Identifier
1073113296
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL CENTER OF GARDENS INC
Practice address
18244 NW 27TH Ave
Miami Gardens, FL 33056-3501
Phone
(305) 456-2680
NPI assigned
Oct 27, 2020
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Enrique Acosta, DDS
Title
President
Phone
(305) 454-0911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

18244 NW 27TH Ave
Miami Gardens, FL 33056-3501

Mailing address

2645 S Douglas Rd Ste 703
Miami, FL 33133-2745
Phone (954) 513-9277

National Provider Directory

National Provider Directory

Locations

18244 NW 27th Ave
Miami Gardens, FL 33056
Phone (305) 454-0911

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1073113296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 S DOUGLAS RD STE 703",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331332745",
            "telephone_number": "954-513-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18244 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330563501",
            "telephone_number": "305-456-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CENTER OF GARDENS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-27",
        "last_updated": "2024-06-04",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-454-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 4, 2024; 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.