NPIMap

Organization Active NPI

Miami Shores Modern Dentistry, PA

Doing business as Miami Shores Modern Dentistry

  • General Practice Dentistry
  • Miami Shores, FL
National Provider Identifier
1427418748
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MIAMI SHORES MODERN DENTISTRY, PA
Doing business as
Miami Shores Modern Dentistry
Practice address
9503 NE 2ND Ave
Miami Shores, FL 33138-2704
Phone
(786) 310-4816
Fax
(786) 623-0927
NPI assigned
Feb 29, 2016
Last updated
Jun 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Dr. Minh B Pham, DDSNPI 1922193754
Title
Owner Dentist
Phone
(786) 310-4816

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

9503 NE 2ND Ave
Miami Shores, FL 33138-2704

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Miami Shores Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

9503 NE 2nd Ave
Miami Shores, FL 33138
Phone (786) 310-4816

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1427418748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9503 NE 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382704",
            "telephone_number": "786-310-4816",
            "fax_number": "786-623-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI SHORES MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "786-310-4816",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miami Shores Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.