Main Street Children'S Dentistry and Orthodontics of Homestead, P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF HOMESTEAD, P.A.

Practice address

925 NE 30TH Ter Ste 110
Homestead, FL 33033-7614

Phone

(305) 274-2499

Fax

(305) 274-9312

NPI assigned

May 13, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie Gomez

Title

Provider Relations Specialist

Phone

(305) 274-2499

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1124310867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST FL 2",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864461",
            "telephone_number": "305-274-2499",
            "fax_number": "305-274-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 NE 30TH TER STE 110",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337614",
            "telephone_number": "305-274-2499",
            "fax_number": "305-274-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF HOMESTEAD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SPECIALIST",
        "authorized_official_telephone_number": "305-274-2499",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Homestead, FL
• Providers in Homestead, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.