Pediatric Dental Center of Biscayne Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN17284 Issued in FL

Legal business name

PEDIATRIC DENTAL CENTER OF BISCAYNE INC

Practice address

557 NE 81St St
Miami, FL 33138-4519

Phone

(786) 368-6212

NPI assigned

Mar 31, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Enrique Acosta, D.D.S,M.B.A

Title

President

Phone

(786) 368-6212

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1154853927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 S DOUGLAS RD",
            "address_2": "SUITE # 703",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331332754",
            "telephone_number": "305-448-3228",
            "fax_number": "305-447-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 NE 81ST ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331384519",
            "telephone_number": "786-368-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CENTER OF BISCAYNE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-368-6212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S,M.B.A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17284",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.