Organization Active NPI

Antonio Otero DDS and Associates, PA

  • Dentist
  • Miami, FL
National Provider Identifier
1417169913
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ANTONIO OTERO DDS AND ASSOCIATES, PA
Practice address
13625 SW 26 Street
Miami, FL 33170
Phone
(305) 552-7626
Fax
(305) 552-8873
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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
Phone
(305) 552-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

13625 SW 26 Street
Miami, FL 33170

Mailing address

13625 SW 26 Street
Miami, FL 33170
Phone (305) 552-7626

Other identifiers 1

IdentifierTypeStateIssuer
077828101MedicaidFL

National Provider Directory

National Provider Directory

Locations

13625 SW 26th St
Miami, FL 33175
Phone (305) 552-7626

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1417169913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 SW 26 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33170",
            "telephone_number": "305-552-7626",
            "fax_number": "305-552-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 SW 26 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33170",
            "telephone_number": "305-552-7626",
            "fax_number": "305-552-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIO OTERO DDS AND ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "OTERO",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-552-7626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077828101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

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