NPIMap

Organization Active NPI

Dentalmed Associates, LLC

  • General Practice Dentistry
  • Miramar, FL
National Provider Identifier
1124363676
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14284 Issued in FL
Legal business name
DENTALMED ASSOCIATES, LLC
Practice address
12600 Pembroke Rd
Suite 314
Miramar, FL 33027-2544
Phone
(954) 505-7631
Fax
(954) 505-7633
NPI assigned
Dec 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Dr. Federico Diez, D.D.SNPI 1043392111
Title
Owner
Phone
(954) 505-7631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X DN13029 FL
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN14284 FL Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DN14345 FL
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X DN-14284 FL

Addresses

Primary practice location

12600 Pembroke Rd
Suite 314
Miramar, FL 33027-2544

Mailing address

12600 Pembroke Rd
Suite 314
Miramar, FL 33027-2544
Phone (954) 505-7631

National Provider Directory

National Provider Directory
Tax ID family
Dentalmed Associates LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12600 Pembroke Rd
Ste 314
Miramar, FL 33027
Phone (954) 505-7631

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1124363676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 PEMBROKE RD",
            "address_2": "SUITE 314",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272544",
            "telephone_number": "954-505-7631",
            "fax_number": "954-505-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 PEMBROKE RD",
            "address_2": "SUITE 314",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272544",
            "telephone_number": "954-505-7631",
            "fax_number": "954-505-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTALMED ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "DIEZ",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-505-7631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13029",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14284",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN14345",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN-14284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.