Elite Wellness & Dental Spa LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ELITE WELLNESS & DENTAL SPA LLC

Doing business as

Elite wellness & Dental Spa LLC

Practice address

3105 NW 107TH Ave Ste 100
Doral, FL 33172-2215

Phone

(786) 200-9120

NPI assigned

Dec 23, 2024

Last updated

Dec 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carlos Lopez

Title

Cfo

Phone

(786) 200-9120

Specialties & licenses 1

Addresses

Other names 1

• Elite wellness & Dental Spa LLC Doing business as

Locations

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1285442228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 NW 107TH AVE STE 100",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 NW 107TH AVE STE 100",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722215",
            "telephone_number": "786-200-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE WELLNESS & DENTAL SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "786-200-9120"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite wellness & Dental Spa LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Doral, FL
• Providers in Doral, 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 Dec 23, 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.