Dental Services of Town and Country, PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN10814 Issued in FL

Legal business name

DENTAL SERVICES OF TOWN AND COUNTRY, PA

Practice address

13776 SW 152ND St
Miami, FL 33177-1163

Phone

(305) 255-8855

NPI assigned

Aug 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Antonio Otero, DDS

Title

President/Owner

Phone

(305) 606-1232

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1376823781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13776 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771163",
            "telephone_number": "305-255-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13776 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771163",
            "telephone_number": "305-255-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES OF TOWN AND COUNTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "OTERO",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "305-606-1232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077828102",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.