Professional Dental Alliance of Homestead Ortho, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF HOMESTEAD ORTHO, PLLC

Practice address

2870 NE 8TH St
Homestead, FL 33033-5695

Phone

(305) 547-8398

NPI assigned

Aug 26, 2019

Last updated

Aug 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren Howard

Title

Credentialing Specialist

Phone

(757) 576-5479

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1124675038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 NE 8TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335695",
            "telephone_number": "305-547-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF HOMESTEAD ORTHO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-576-5479"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Princeton Home Care, LLC
• Private Circle Care LLC
• Procare Orthopedics, Inc
• Procare Orthopedics, Inc
• Professional Ba Skills LLC
• Professional Dental Alliance of Homestead, PLLC
• Professional Hands Rehabilitation Center Corp
• Professional Medical Equipment & Supply Inc
• Professional Nurse Practitioner Inc
• Professional Services Care Inc.

• 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 26, 2019; 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.