NPIMap

Organization Active NPI

Dental Specialists of Homestead

  • Dental Clinic/Center
  • Homestead, FL
National Provider Identifier
1417592247
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DENTAL SPECIALISTS OF HOMESTEAD
Doing business as
Dental Specialists of Homestead
Practice address
190 NW 14TH St
Homestead, FL 33030-4240
Phone
(786) 355-4401
Fax
(305) 220-9966
NPI assigned
Nov 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Authorized official

Name
Ivan Pelton, DMD
Title
Administrative Operator
Phone
(305) 530-8115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

190 NW 14TH St
Homestead, FL 33030-4240

Mailing address

10666 Fontainebleau Blvd
Miami, FL 33172-3117
Phone (305) 220-8911

Other identifiers 1

IdentifierTypeStateIssuer
P435417372860OtherFLDRIVERS LICENSE

Other names 1

  • Dental Specialists of Homestead Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsdoral@outlook.com Direct

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1417592247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10666 FONTAINEBLEAU BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723117",
            "telephone_number": "305-220-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 NW 14TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304240",
            "telephone_number": "786-355-4401",
            "fax_number": "305-220-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF HOMESTEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "PELTON",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "ADMINISTRATIVE OPERATOR",
        "authorized_official_telephone_number": "305-530-8115",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "P435417372860",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsdoral@outlook.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "190 NW 14th St",
            "city": "Homestead",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330304240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dental Specialists of Homestead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.