NPIMap

Organization Active NPI

Pediatric Dental Center of Palmetto Bay Inc

  • Pediatric Dentistry
  • Palmetto Bay, FL
National Provider Identifier
1164003786
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL CENTER OF PALMETTO BAY INC
Practice address
17037 S Dixie Hwy
Palmetto Bay, FL 33157-4362
Phone
(786) 368-6212
NPI assigned
Apr 15, 2021
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Enrique Acosta, DDS
Title
President
Phone
(786) 732-0802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

17037 S Dixie Hwy
Palmetto Bay, FL 33157-4362

Mailing address

17037 S Dixie Hwy
Palmetto Bay, FL 33157-4362
Phone (786) 368-6212

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1164003786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17037 S DIXIE HWY",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331574362",
            "telephone_number": "786-368-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17037 S DIXIE HWY",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331574362",
            "telephone_number": "786-368-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CENTER OF PALMETTO BAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-06-04",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-732-0802",
        "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": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.