Main Street Children'S Dentistry and Orthodontics at London Square, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS AT LONDON SQUARE, PA

Doing business as

Dental Associates of West Kendall

Practice address

13400 SW 120TH St
Ste 310
Miami, FL 33186-7440

Phone

(305) 255-9541

NPI assigned

Oct 30, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie Gomez

Title

Provider Relations Specialist

Phone

(305) 274-2499

Specialties & licenses 4

Addresses

Other names 1

• Dental Associates of West Kendall Doing business as

Tax ID family

Dental Associates of West Kendall2 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 Children'S Dentistry and Orthodontics of London Square, PA

  • General Practice Dentistry
  • Miami, FL
  • NPI 1467782839
  NPD tax ID

Locations

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1174859896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST FL 2",
            "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": "13400 SW 120TH ST",
            "address_2": "STE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331867440",
            "telephone_number": "305-255-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS AT LONDON SQUARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SPECIALIST",
        "authorized_official_telephone_number": "305-274-2499",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN5380",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Associates of West Kendall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Main Street Children'S Dentistry and Orthodontics of London Square, PA
• Main Street Orthodontics of Kendall, PA
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• Yunior Mainegra
• Hardik Maini, PHARMD

• 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 Aug 4, 2014; 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.