Salome Fraga, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN23439 Issued in FL

Practice address

9971 W Flagler Street
Suite 220
Miami, FL 33174

Phone

(786) 417-3074

NPI assigned

Jul 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1205322856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15853 SW 43 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33185",
            "telephone_number": "305-223-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9971 W FLAGLER STREET",
            "address_2": "SUITE 220",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33174",
            "telephone_number": "786-417-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGA",
        "first_name": "SALOME",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "23439",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011897600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enrique Z Fraga, MD
• Joyce Fraga
• Lisbet Fraga
• Nahir Fraga, MSN
• Norci Fraga
• Yaliuska Fraga
• Yanisleidy Fraga, OTR
• Francoise Rose Anastasie Frage, SA-C
• Merlande Fragelus
• Barbara Ingrid Fragoso, BCBA

• General Practice Dentistry in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.