Individual provider Active NPI

Juan C Amundaray, DDS

  • Dentist
  • Miami Beach, FL
National Provider Identifier
1306218797
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15270 Issued in FL
Practice address
710 Alton Rd
Miami Beach, FL 33139-5504
Phone
(305) 538-8835
Fax
(305) 994-0054
NPI assigned
Oct 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN15270 FL Primary

Addresses

Primary practice location

710 Alton Rd
Miami Beach, FL 33139-5504

Mailing address

11645 Biscayne Blvd Ste 207
Miami, FL 33181-3138
Phone (305) 538-8835

Other practice location 1

11645 Biscayne Blvd Ste 401
Miami, FL 33181-3139
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
103735000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231009001963 FL Practitioner - Dentist 6608204342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Beach Community Health Center Inc CurrentSince Jun 3, 2023 Accepting new patients
Miami Beach Community Health Center Inc CurrentSince Jun 3, 2023 Accepting new patients

Locations

710 Alton Rd
Miami Beach, FL 33139

11645 Biscayne Blvd
Ste 401
North Miami, FL 33181

11645 Biscayne Blvd
Ste 207
North Miami, FL 33181
Phone (704) 297-9229

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1306218797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331395504",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11645 Biscayne Blvd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331813139",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMUNDARAY",
        "first_name": "JUAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-24",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103735000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.