Jose Luis Chaviano Jr., D.M.D
Individual provider Active NPI General Practice Dentistry · Key Biscayne, FL
NPI 1487010245 · NPPES record last updated May 17, 2016
Key facts
- NPI
- 1487010245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN21485 (FL)
- Practice address
- 240 Crandon Blvd
Suite 104
Key Biscayne, FL 33149-1543 - Phone
- (305) 361-5493
- NPI assigned
- Jan 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN21485 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illustradent Key Biscayne PLLC | Past | Accepting new patients | |
| South Miami Dental Service PA | Past | Accepting new patients | |
| Jose L Chaviano Jr | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN21485 | FL | Yes |
Addresses
Primary practice location
240 Crandon Blvd
Suite 104
Key Biscayne, FL 33149-1543
Mailing address
1407 W 38TH St
Hialeah, FL 33012-4745
Phone (305) 967-2175
Other providers in Key Biscayne, FL
- Josefina Campiani
- Carmen J Ortiz Butcher MD PA
- Tatiana Caro
- Anita Carrillo
- Jean-Pierre Chacon
- Chia Ling Chow-Watson
- Mauricio Coro
- D.B.M. Distributors
- Mercedes Margarita De Cubas
- Elaine Simone De Roode
All providers in Key Biscayne, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.