Ivanov Miami Lakes PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

IVANOV MIAMI LAKES PLLC

Practice address

16375 NW 67TH Ave
Miami Lakes, FL 33014-6044

Phone

(786) 946-0005

Fax

(786) 946-0019

NPI assigned

Mar 4, 2025

Organization subpart

No

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

Authorized official

Name

Pavel Ivanov, DMDNPI 1790020824

Title

President

Phone

(954) 240-4016

Specialties & licenses 1

Addresses

Other names 1

• Ivanov Orthodontics 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.

• Pavel Ivanov Ivanov, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • North Miami, FL
  • NPI 1790020824
  NPD Authorized official

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1245038462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16375 NW 67TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146044",
            "telephone_number": "786-946-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16375 NW 67TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146044",
            "telephone_number": "786-946-0005",
            "fax_number": "786-946-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVANOV MIAMI LAKES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "IVANOV",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-240-4016",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivanov Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isabela House Inc
• Michael Richard Iser, PT, DPT
• Noemi Istueta, OTR/L
• Sandra Italiano, MA, LPC
• Ivan Terrero DDS PA
• Yosbel Izquierdo Perez
• Armando Izquierdo, NP
• Lay Izquierdo
• Rene J Izquierdo
• J & G Therapeutics Center Inc

• Orthodontics and Dentofacial Orthopedics Dentistry in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.