Main Street Orthodontics of Miami Lakes, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAIN STREET ORTHODONTICS OF MIAMI LAKES, P.A.

Doing business as

Main Street Children's Dentistry of Miami Lakes

Practice address

15600 NW 67TH Ave
Suite 110
Miami Lakes, FL 33014-2174

Phone

(305) 823-8831

Fax

(305) 823-8799

NPI assigned

Feb 4, 2010

Last updated

Jul 10, 2012By 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

Dr. Melvyn Gober, DDS

Title

Ceo

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Other names 1

• Main Street Children's Dentistry of Miami Lakes Doing business as

Tax ID family

Main Street Children's Dentistry of Miami Lakes2 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.

• Main Street Orthodontics of Miami Lakes, PA

  dba Main Street Children's Dentistry of Miami Lakes

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Miami Lakes, FL
  • NPI 1811009194
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aline Morin, DMD, MS

  • Pediatric Dentistry
  • Coral Springs, FL
  • NPI 1932487725
  NPD (past)
• Jeffrey A Weiss, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Miami Lakes, FL
  • NPI 1790872042
  NPD (past)

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1154653913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST",
            "address_2": "2ND FLOOR",
            "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": "15600 NW 67TH AVE",
            "address_2": "SUITE 110",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "305-823-8831",
            "fax_number": "305-823-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET ORTHODONTICS OF MIAMI LAKES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "GOBER",
        "authorized_official_first_name": "MELVYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-274-2499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Children's Dentistry of Miami Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Magna Physical Therapy, LLC
• Sharon Mahabir
• David CHI Mai, D.P.M.
• Maidelys Oliva DMD PA (Olive Tree Pediatric Dentistry)
• Main Street Children's Dentistry of Miami Lakes, PLLC
• Main Street Orthodontics of Miami Lakes, PA (Main Street Children's Dentistry of Miami Lakes)
• Maju's Home Care, Inc. (Aging Care Concepts, Inc.)
• Yusnely Makence Letts
• Daniella J Maldonado-Ortega
• Ivelisse Maldonado, PHARM D

• Pediatric Dentistry in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.