Vidamax Dental Group Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

VIDAMAX DENTAL GROUP CORP

Practice address

2040 Washington St
Hollywood, FL 33020-6930

Phone

(754) 348-5001

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Raisa Cortes FontanetNPI 1124505268

Title

Owner

Phone

(786) 715-5571

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raisa Cortes Fontanet

  • General Practice Dentistry
  • Coral Gables, FL
  • NPI 1124505268
  NPD Authorized official

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1417604166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 WASHINGTON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206930",
            "telephone_number": "754-348-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 WASHINGTON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206930",
            "telephone_number": "754-348-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDAMAX DENTAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "CORTES FONTANET",
        "authorized_official_first_name": "RAISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-715-5571"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Vick, ARNP
• Vick'S Medical, LLC
• Victoria Valdesuso PA
• Victorian Manor Assisted Living Facility
• Lisbet Vidal, O.D.
• Vidawell Care LLC
• Vidawell Care LLC
• Brian Viel Barros
• Stevens Viera
• Bethany Vigroux, PA

• Dental Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.