NPIMap

Organization Active NPI

Beach Dental Specialist

  • Periodontics
  • Miami, FL
National Provider Identifier
1477894079
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN18253 Issued in FL
Legal business name
BEACH DENTAL SPECIALIST
Practice address
4011 W Flagler St.
505
Miami, FL 33134
Phone
(305) 424-2705
Fax
(305) 643-0447
NPI assigned
Mar 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Authorized official

Name
Edy Augusto Guerra
Title
President
Phone
(305) 424-2705

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X DN18777 FL
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DN18253 FL Primary

Addresses

Primary practice location

4011 W Flagler St.
505
Miami, FL 33134

Mailing address

4011 W Flagler St.
505
Miami, FL 33134
Phone (305) 424-2705

National Provider Directory

National Provider Directory

Locations

4011 W Flagler St
Ste 505
Coral Gables, FL 33134
Phone (305) 424-2705

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1477894079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 W FLAGLER ST.",
            "address_2": "505",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-424-2705",
            "fax_number": "305-643-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 W FLAGLER ST.",
            "address_2": "505",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-424-2705",
            "fax_number": "305-643-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH DENTAL SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "EDY",
        "authorized_official_middle_name": "AUGUSTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-424-2705"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN18777",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN18253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 6, 2013; 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.