Individual provider Active NPI

Abel O De Anna, D.M.D

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1104077502
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7784 Issued in FL
Practice address
12700 SW 128TH St Ste 203
Miami, FL 33186-5378
Phone
(786) 206-8003
NPI assigned
Oct 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7784 FL Primary

Addresses

Primary practice location

12700 SW 128TH St Ste 203
Miami, FL 33186-5378

Mailing address

2901 S Bayshore Dr
Apt 4F
Miami, FL 33133-6001
Phone (305) 505-4768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7784FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1104077502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 S BAYSHORE DR",
            "address_2": "APT 4F",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331336001",
            "telephone_number": "305-505-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SW 128TH ST STE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865378",
            "telephone_number": "786-206-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ANNA",
        "first_name": "ABEL",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "7784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.