NPIMap

Organization Active NPI

Doral Pediatric Dentistry

Doing business as Kendall Pediatric Dentistry

  • Dentist
  • Miami, FL
National Provider Identifier
1437603446
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DORAL PEDIATRIC DENTISTRY
Doing business as
Kendall Pediatric Dentistry
Practice address
13757 SW 152ND St
Miami, FL 33177-8125
Phone
(305) 251-5390
NPI assigned
Aug 8, 2016
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DORAL PEDIATRIC DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Juan L Garrastazu, DMDNPI 1043382138
Title
Owner
Phone
(305) 251-5390

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
Dentist 122300000X Primary

Addresses

Primary practice location

13757 SW 152ND St
Miami, FL 33177-8125

Mailing address

13757 SW 152ND St
Miami, FL 33177-8125
Phone (305) 251-5390

Other names 1

  • Kendall Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Doral Pediatric Dentistry LLC2 organizations share this tax ID, including this one
Part of
Doral Pediatric Dentistry LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13757 SW 152nd St
Miami, FL 33177
Phone (305) 251-5390

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1437603446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13757 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331778125",
            "telephone_number": "305-251-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13757 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331778125",
            "telephone_number": "305-251-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORAL PEDIATRIC DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DORAL PEDIATRIC DENTISTRY",
        "enumeration_date": "2016-08-08",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "GARRASTAZU",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-251-5390",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kendall Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kendall Pediatric Dentistry",
            "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 Sep 6, 2023; 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.