Individual provider Active NPI

Diana Perez, DMD

  • General Practice Dentistry
  • Hialeah, FL
National Provider Identifier
1194455329
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN27022 Issued in FL
Practice address
17776 NW 57TH Ave
Hialeah, FL 33015-5118
Phone
(786) 587-8540
NPI assigned
Jun 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 569002939 FL
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN27022 FL Primary

Addresses

Primary practice location

17776 NW 57TH Ave
Hialeah, FL 33015-5118

Mailing address

17776 NW 57TH Ave
Hialeah, FL 33015-5118
Phone (786) 587-8540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
569002939FLMDGeneral Practice Dentistry
DN27022FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Miami Gardens, PA General Practice CurrentSince Jun 21, 2022 Accepting new patients

Locations

17776 NW 57th Ave
Hialeah, FL 33015
Phone (786) 579-1206

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1194455329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17776 NW 57TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155118",
            "telephone_number": "786-587-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17776 NW 57TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155118",
            "telephone_number": "786-587-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "DIANA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "569002939",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN27022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.