NPIMap

Organization Active NPI

Prime Pediatric Dental Group PA

  • Pediatric Dentistry
  • Doral, FL
National Provider Identifier
1306715263
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PRIME PEDIATRIC DENTAL GROUP PA
Practice address
10717 NW 58TH St
Doral, FL 33178-2801
Phone
(305) 513-4058
NPI assigned
Oct 30, 2025
Organization subpart
Yes
Parent organization
PRIME PEDIATRIC DENTAL GROUP PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Dr. Jose I Delgado
Title
Advisor
Phone
(904) 806-7080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

10717 NW 58TH St
Doral, FL 33178-2801

Mailing address

10717 NW 58TH St
Doral, FL 33178-2801
Phone (305) 513-4058

National Provider Directory

National Provider Directory
Tax ID family
Prime Pediatric Dental Group PA6 organizations share this tax ID, including this one
Part of
Prime Pediatric Dental Group PA

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1306715263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 NW 58TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782801",
            "telephone_number": "305-513-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10717 NW 58TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782801",
            "telephone_number": "305-513-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PEDIATRIC DENTAL GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME PEDIATRIC DENTAL GROUP PA",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADVISOR",
        "authorized_official_telephone_number": "904-806-7080",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.