Dental Center of Country Walk, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DENTAL CENTER OF COUNTRY WALK, LLC

Doing business as

Dental Center of Country Walk

Practice address

15721 SW 152ND St
Miami, FL 33187-5417

Phone

(305) 233-3335

Fax

(305) 233-3909

NPI assigned

Oct 11, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Nick Lekkas, DDS

Title

Owner

Phone

(954) 383-4973

Specialties & licenses 1

Addresses

Other names 1

• Dental Center of Country Walk Doing business as

Locations

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1467737304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15721 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331875417",
            "telephone_number": "305-233-3335",
            "fax_number": "305-233-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15721 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331875417",
            "telephone_number": "305-233-3335",
            "fax_number": "305-233-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CENTER OF COUNTRY WALK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-11",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "LEKKAS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-383-4973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Center of Country Walk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.