Individual provider Active NPI

Marta Ortiz-Perez, DMD

  • Dentist
  • Miami, FL
National Provider Identifier
1194883835
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 14474 Issued in FL
Practice address
Pediatric Dental Associates
13846 SW 56 Street
Miami, FL 33175
Phone
(305) 380-8050
Fax
(305) 385-9122
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 14474 FL Primary

Addresses

Primary practice location

Pediatric Dental Associates
13846 SW 56 Street
Miami, FL 33175

Mailing address

13846 SW 56 Street
Miami, FL 33175
Phone (305) 380-8050

Other identifiers 1

IdentifierTypeStateIssuer
071513101MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225000096 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2163727488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 14474FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1194883835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13846 SW 56 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33175",
            "telephone_number": "305-380-8050",
            "fax_number": "305-385-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEDIATRIC DENTAL ASSOCIATES",
            "address_2": "13846 SW 56 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33175",
            "telephone_number": "305-380-8050",
            "fax_number": "305-385-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ-PEREZ",
        "first_name": "MARTA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 14474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071513101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.