Elitedent PB

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ELITEDENT PB

Practice address

16935 S Dixie Hwy
Palmetto Bay, FL 33157-4361

Phone

(305) 646-6700

NPI assigned

Oct 7, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline CorreaNPI 1053516732

Title

President

Phone

(786) 351-5050

Specialties & licenses 1

Addresses

Other names 1

• EliteDent PB Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Correa, D. M. D.

  • General Practice Dentistry
  • Miami, FL
  • NPI 1053516732
  NPD Authorized official

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1205655347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16935 S DIXIE HWY",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331574361",
            "telephone_number": "305-646-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16935 S DIXIE HWY",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331574361",
            "telephone_number": "305-646-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITEDENT PB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-351-5050",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EliteDent PB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Early Intervention Behavioral Services Corp
• Wendy Phreud Edmond, AC-AGNP
• Edward L Cutler MD Fa CP Professional Association
• Elder Life Mental Health Inc
• Elder Life Mental Health Inc
• Emergent Physicians of Palmetto Bay, LLC
• Daisy Enamorado
• Alexandra Englert, LMHC, LMFT
• Alexandra N Esco, RMHCI
• Raul Franco Escobar, MD

• Dental Clinic/Center in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.