International Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1834 Issued in FL

Legal business name

INTERNATIONAL DENTAL GROUP

Practice address

1030 N Royal Poinciana Blvd
Miami Springs, FL 33166-3257

Phone

(786) 558-4100

Fax

(866) 305-9918

NPI assigned

Jun 8, 2013

Organization subpart

No

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

Authorized official

Name

Renate E Manns

Title

VP

Phone

(786) 558-4100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1370649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370649600000",
    "number": "1558709873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N ROYAL POINCIANA BLVD",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331663257",
            "telephone_number": "786-558-4100",
            "fax_number": "866-305-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N ROYAL POINCIANA BLVD",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331663257",
            "telephone_number": "786-558-4100",
            "fax_number": "866-305-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-08",
        "last_updated": "2013-06-08",
        "status": "A",
        "authorized_official_last_name": "MANNS",
        "authorized_official_first_name": "RENATE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "786-558-4100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN1834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Miami Springs, FL
• Providers in Miami Springs, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.