The Family Dental Care Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

THE FAMILY DENTAL CARE CENTER

Practice address

646 W Palm Dr
Homestead, FL 33034-3208

Phone

(305) 242-1200

Fax

(305) 242-8782

NPI assigned

Jan 15, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Alejandro De la Cruz, D.D.S

Title

President

Phone

(305) 242-1200

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Family Dental Care Center Former legal business name

Locations

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1184861981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 W PALM DR",
            "address_2": "202",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330343208",
            "telephone_number": "305-242-1200",
            "fax_number": "305-242-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 W PALM DR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330343208",
            "telephone_number": "305-242-1200",
            "fax_number": "305-242-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY DENTAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-15",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-242-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070376101",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0755532 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Dental Care Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.