NPIMap

Organization Active NPI

Sofia Fontecilla DDS PA

Doing business as Coconut Grove Dental

  • Dental Clinic/Center
  • Miami, FL
National Provider Identifier
1437510211
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
20387 Issued in FL
Legal business name
SOFIA FONTECILLA DDS PA
Doing business as
Coconut Grove Dental
Practice address
3220 S Dixie Hwy
#101
Miami, FL 33133-3609
Phone
(786) 353-0735
NPI assigned
Mar 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Sofia Fontecilla, DDSNPI 1962780882
Title
President
Phone
(786) 353-0735

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
Dental Clinic/Center 261QD0000X 20387 FL Primary

Addresses

Primary practice location

3220 S Dixie Hwy
#101
Miami, FL 33133-3609

Mailing address

3220 S Dixie Hwy
#101
Miami, FL 33133-3609
Phone (786) 353-0735

Other names 1

  • Coconut Grove Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1437510211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 S DIXIE HWY",
            "address_2": "#101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331333609",
            "telephone_number": "786-353-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 S DIXIE HWY",
            "address_2": "#101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331333609",
            "telephone_number": "786-353-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOFIA FONTECILLA DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "FONTECILLA",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-353-0735",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "20387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coconut Grove Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 8, 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.