Individual provider Active NPI

Ieshy Soley Pereira, D.M.D

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1558788836
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN22101 Issued in FL
Practice address
350 NE 24 St
#105
Miami, FL 33137
Phone
(305) 572-1600
NPI assigned
Mar 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN22101 FL Primary

Addresses

Primary practice location

350 NE 24 St
#105
Miami, FL 33137

Mailing address

12580 Croton Rd
North Miami, FL 33181-2637
Phone (305) 263-0818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN22101FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Julio E Hernandez DMD PA General Practice PastSince May 24, 2020 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": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1558788836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12580 CROTON RD",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331812637",
            "telephone_number": "305-263-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NE 24 ST",
            "address_2": "#105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33137",
            "telephone_number": "305-572-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "IESHY",
        "middle_name": "SOLEY",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.