Individual provider Active NPI

Martha Maderal, DDS

  • Dentist
  • Miami Lakes, FL
National Provider Identifier
1497870083
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN11118 Issued in FL
Practice address
6500 Cowpen Rd
Suite 104
Miami Lakes, FL 33014
Phone
(305) 827-3926
Fax
(305) 827-8109
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN11118 FL Primary

Addresses

Primary practice location

6500 Cowpen Rd
Suite 104
Miami Lakes, FL 33014

Mailing address

6500 Cowpen Rd
Suite 104
Miami Lakes, FL 33014
Phone (305) 827-3926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160505001763 FL Order and Referring Only - DentistPractitioner - Dentist 2163721598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Smile Center PA Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1497870083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 COWPEN RD",
            "address_2": "SUITE 104",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33014",
            "telephone_number": "305-827-3926",
            "fax_number": "305-827-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 COWPEN RD",
            "address_2": "SUITE 104",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33014",
            "telephone_number": "305-827-3926",
            "fax_number": "305-827-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADERAL",
        "first_name": "MARTHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.