NPIMap

Organization Active NPI

FL Southern Dental PPO PA

  • Dentist
  • Miami Beach, FL
National Provider Identifier
1295524825
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FL SOUTHERN DENTAL PPO PA
Practice address
925 Arthur Godfrey Rd Ste 302
Miami Beach, FL 33140-3339
Phone
(786) 207-3179
NPI assigned
May 1, 2025
Organization subpart
Yes
Parent organization
FL SOUTHERN DENTAL PPO PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Erika Melissa Menjivar
Title
Sr. Credentialing Specialist
Phone
(469) 596-6137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

925 Arthur Godfrey Rd Ste 302
Miami Beach, FL 33140-3339

Mailing address

5830 Granite Pkwy Ste 780
Plano, TX 75024-6775

Other names 1

  • Beach Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
FL Southern Dental PPO PA10 organizations share this tax ID, including this one
Part of
FL Southern Dental PPO PA

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

925 Arthur Godfrey Rd
Ste 302
Miami Beach, FL 33140
Phone (305) 535-3113

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1295524825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 GRANITE PKWY STE 780",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 ARTHUR GODFREY RD STE 302",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403339",
            "telephone_number": "786-207-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FL SOUTHERN DENTAL PPO PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FL SOUTHERN DENTAL PPO PA",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "MENJIVAR",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "SR. CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "469-596-6137"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beach Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami Beach, FL

Sources for this page

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