NPIMap

Organization Active NPI

Monika Srivastava DMD PA West

  • Pediatric Dentistry
  • Pembroke Pines, FL
National Provider Identifier
1295269116
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
MONIKA SRIVASTAVA DMD PA WEST
Doing business as
JACARANDA SMILES CHILDREN'S DENTISTRY AND ORTHODONTICS
Practice address
18503 Pines Blvd
Suite 209
Pembroke Pines, FL 33029-1404
Phone
(954) 436-0502
Fax
(954) 436-0503
NPI assigned
Apr 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Dr. Monika Srivastava, DMDNPI 1790935898
Title
Owner/Dentist
Phone
(267) 909-9551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

18503 Pines Blvd
Suite 209
Pembroke Pines, FL 33029-1404

Mailing address

18503 Pines Blvd
Suite 209
Pembroke Pines, FL 33029-1404
Phone (954) 436-0502

Other identifiers 1

IdentifierTypeStateIssuer
003557500MedicaidFL

Other names 1

  • JACARANDA SMILES CHILDREN'S DENTISTRY AND ORTHODONTICS Doing business as

National Provider Directory

National Provider Directory

Locations

18503 Pines Blvd
Ste 209
Pembroke Pines, FL 33029
Phone (954) 436-0502

Practitioners & affiliated clinicians

Practitioners 2

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": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1295269116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD",
            "address_2": "SUITE 209",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291404",
            "telephone_number": "954-436-0502",
            "fax_number": "954-436-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD",
            "address_2": "SUITE 209",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291404",
            "telephone_number": "954-436-0502",
            "fax_number": "954-436-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONIKA SRIVASTAVA DMD PA WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "267-909-9551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003557500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACARANDA SMILES CHILDREN'S DENTISTRY AND ORTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.