Main Street Children'S Dentistry & Orthodontics of Palmetto Bay, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF PALMETTO BAY, PA

Doing business as

Main Street Children's Denistry of Palmetto Bay

Practice address

8805 SW 144TH St
Palmetto Bay, FL 33176-7218

Phone

(305) 253-6944

Fax

(305) 251-9989

NPI assigned

Nov 13, 2009

Organization subpart

No

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

Authorized official

Name

Stephanie Gomez

Title

Credentialing Supervisor

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Other names 1

• Main Street Children's Denistry of Palmetto Bay Doing business as

Locations

Practitioners 2

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

• Bruce M. Mahaffey, D.M.D.

  • Pediatric Dentistry
  • Village of Palmetto Bay, FL
  • NPI 1003871781
  NPD (past)
• Fabiola D Ortega, DDS

  • Pediatric Dentistry
  • Palmetto Bay, FL
  • NPI 1790002038
  NPD (past)

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174850093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 134 ST",
            "address_2": "2ND FLOOR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33186",
            "telephone_number": "305-274-2499",
            "fax_number": "305-251-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 SW 144TH ST",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331767218",
            "telephone_number": "305-253-6944",
            "fax_number": "305-251-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF PALMETTO BAY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Children's Denistry of Palmetto Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Mabjeesh, DDS
• Mark J Macgowan, PHD LCSW
• Mel Macias Mestre
• Maria Gabriella Madriz, LCSW
• Magnolia Sleep Center and Wellness, LLC
• Caitlin Jeanette Maitre, OT/L
• Jarvis Javon Major
• Rene Merlin Malary, RRT
• Adianet Marin Lobaina
• Adriana Stella Marin

• Pediatric Dentistry in Palmetto Bay, FL
• Providers in Palmetto Bay, 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 21, 2022; 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.