Organization Active NPI

Nutridentist

  • General Practice Dentistry
  • Homestead, FL
National Provider Identifier
1568190247
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NUTRIDENTIST
Practice address
311 NE 8TH St Ste 107
Homestead, FL 33030-4734
Phone
(305) 245-3144
NPI assigned
Aug 10, 2022
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Laura Perez Morejon, DMDNPI 1770212250
Title
Dentist
Phone
(786) 298-4612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

311 NE 8TH St Ste 107
Homestead, FL 33030-4734

Mailing address

9453 SW 174TH St
Palmetto Bay, FL 33157-5614

National Provider Directory

National Provider Directory

Locations

311 NE 8th St
Ste 107
Homestead, FL 33030
Phone (305) 245-3144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1568190247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9453 SW 174TH ST",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331575614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NE 8TH ST STE 107",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304734",
            "telephone_number": "305-245-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIDENTIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "PEREZ MOREJON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "786-298-4612",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

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