NPIMap

Organization Active NPI

Ebenezer Dental Group

  • Dentist
  • Hialeah, FL
National Provider Identifier
1356799878
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN13262 Issued in FL
Legal business name
EBENEZER DENTAL GROUP
Practice address
4301 Palm Ave
Suite F
Hialeah, FL 33012-4060
Phone
(305) 826-8980
Fax
(305) 826-0991
NPI assigned
May 25, 2016
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Manuel Abreu, DDS
Title
Doctor
Phone
(305) 826-8980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN13262 FL Primary

Addresses

Primary practice location

4301 Palm Ave
Suite F
Hialeah, FL 33012-4060

Mailing address

4301 Palm Ave
Suite F
Hialeah, FL 33012-4060
Phone (305) 826-8980

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1356799878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 PALM AVE",
            "address_2": "SUITE F",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124060",
            "telephone_number": "305-826-8980",
            "fax_number": "305-826-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 PALM AVE",
            "address_2": "SUITE F",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124060",
            "telephone_number": "305-826-8980",
            "fax_number": "305-826-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "ABREU",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "305-826-8980",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN13262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.