Dixie Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN12593 Issued in FL

Legal business name

DIXIE DENTAL CORP

Doing business as

Dental American Group

Practice address

8718 SW 72ND St
Miami, FL 33173-3512

Phone

(305) 273-9330

Fax

(305) 273-9331

NPI assigned

Sep 12, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Manuel Gonzalez

Title

General Manager

Phone

(305) 512-4589

Specialties & licenses 1

Addresses

Other names 1

• Dental American Group Doing business as

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1093263618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 W 84TH ST STE 317",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330184944",
            "telephone_number": "305-512-4589",
            "fax_number": "305-273-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8718 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733512",
            "telephone_number": "305-273-9330",
            "fax_number": "305-273-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "305-512-4589",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental American Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason R. Divito, D.O.
• Juan Pablo Divo Carrera, SA-C
• Maria Churaman Diwanji, M.D.
• Tejan P Diwanji, MD
• Dixie Community Care Inc
• Dixie Medical Center Inc
• Sharese Ameka Dixon-Banks, DNAP, CRNA
• Courtney Elizabeth Dixon, DC
• Ikara Dixon
• Sapphire Dixon, M.A., BCBA

• General Practice Dentistry in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.