Individual provider Active NPI

Vanessa Benabe, DMD

  • Dentist
  • Hialeah, FL
National Provider Identifier
1366510174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0012864 Issued in FL
Practice address
1075 E 4 Ave
Hialeah, FL 33010
Phone
(305) 558-3811
Fax
(305) 888-4324
NPI assigned
Dec 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN0012864 FL Primary

Addresses

Primary practice location

1075 E 4 Ave
Hialeah, FL 33010

Mailing address

1075 E 4 Ave
Hialeah, FL 33010
Phone (305) 558-3811

Other identifiers 1

IdentifierTypeStateIssuer
071778900MedicaidFL

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
I20160315001676 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002112216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0012864FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Dorrego DDS PA Dentist Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366510174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 E 4 AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33010",
            "telephone_number": "305-558-3811",
            "fax_number": "305-888-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E 4 AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33010",
            "telephone_number": "305-558-3811",
            "fax_number": "305-888-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENABE",
        "first_name": "VANESSA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0012864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071778900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.