Tooth Fairy Dental I LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TOOTH FAIRY DENTAL I LLC

Practice address

15495 Eagle Nest LN Ste 110
Miami Lakes, FL 33014-2242

Phone

(561) 891-9046

NPI assigned

Feb 10, 2022

Organization subpart

No

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

Authorized official

Name

Scott Spencer, DOCTOR

Title

Owner

Phone

(561) 891-9046

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1487308201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15495 EAGLE NEST LN STE 110",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142242",
            "telephone_number": "561-891-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15495 EAGLE NEST LN STE 110",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142242",
            "telephone_number": "561-891-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH FAIRY DENTAL I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-891-9046",
        "authorized_official_credential": "DOCTOR"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "littlesmilesdentalbb@hotmail.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15495 Eagle Nest Ln Ste 110",
            "city": "Miami Lakes",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330142242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dental Clinic/Center in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.