Organization Active NPI

Jacarreno DDS PA

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1295029700
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN7219 Issued in FL
Legal business name
JACARRENO DDS PA
Practice address
10688 Coral Way
Miami, FL 33165-7917
Phone
(305) 553-1640
Fax
(305) 271-1167
NPI assigned
Jun 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Dr. Jose Antonio Carreno, DDS
Title
President
Phone
(305) 553-1640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN7219 FL Primary

Addresses

Primary practice location

10688 Coral Way
Miami, FL 33165-7917

Mailing address

10688 Coral Way
Miami, FL 33165-7917
Phone (305) 553-1640

Other names 1

  • dental office Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1295029700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10688 CORAL WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657917",
            "telephone_number": "305-553-1640",
            "fax_number": "305-271-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10688 CORAL WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657917",
            "telephone_number": "305-553-1640",
            "fax_number": "305-271-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACARRENO DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "CARRENO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-553-1640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN7219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dental office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.