Individual provider Active NPI

Alfredo Domingo Corpas Jr., DDS

  • Dentist
  • Cutler Bay, FL
National Provider Identifier
1124115837
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0013451 Issued in FL
Practice address
18545 S Dixie Hwy
Cutler Bay, FL 33157-6845
Phone
(305) 259-9130
Fax
(305) 259-9120
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN0013451 FL Primary

Addresses

Primary practice location

18545 S Dixie Hwy
Cutler Bay, FL 33157-6845

Mailing address

18545 S Dixie Hwy
Cutler Bay, FL 33157-6845
Phone (305) 259-9130

Other identifiers 1

IdentifierTypeStateIssuer
076609700MedicaidFL

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
DN0013451FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1124115837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18545 S DIXIE HWY",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576845",
            "telephone_number": "305-259-9130",
            "fax_number": "305-259-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18545 S DIXIE HWY",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576845",
            "telephone_number": "305-259-9130",
            "fax_number": "305-259-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPAS",
        "first_name": "ALFREDO",
        "middle_name": "DOMINGO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0013451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076609700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.