NPIMap

Organization Active NPI

Prime Pediatric Dental Group PA

  • Pediatric Dentistry
  • North Miami, FL
National Provider Identifier
1487426482
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PRIME PEDIATRIC DENTAL GROUP PA
Practice address
13195 Biscayne Bay Dr
North Miami, FL 33181-2204
Phone
(305) 251-5390
Fax
(305) 675-3282
NPI assigned
Oct 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Dr. Jose Mellado, DMD
Title
President
Phone
(305) 321-3790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

13195 Biscayne Bay Dr
North Miami, FL 33181-2204

Mailing address

13195 Biscayne Bay Dr
North Miami, FL 33181-2204
Phone (305) 251-5390

National Provider Directory

National Provider Directory
Tax ID family
Prime Pediatric Dental Group PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1487426482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 BISCAYNE BAY DR",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331812204",
            "telephone_number": "305-251-5390",
            "fax_number": "305-675-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 BISCAYNE BAY DR",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331812204",
            "telephone_number": "305-251-5390",
            "fax_number": "305-675-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PEDIATRIC DENTAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "MELLADO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-321-3790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.