Westland Mall Dental, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WESTLAND MALL DENTAL, PA

Practice address

1665 W 49TH St Ste 1484
Hialeah, FL 33012-2957

Phone

(305) 828-7779

Fax

(305) 828-7651

NPI assigned

Dec 22, 2008

Organization subpart

No

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

Authorized official

Name

Rostislav Krasnov, DDS

Title

Owner

Phone

(305) 828-7779

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Christian Montenegro Valor, DMD

  • General Practice Dentistry
  • Hialeah, FL
  • NPI 1144714445
  NPD (past)
• Mohamed Sirage

  • Pediatric Dentistry
  • Plantation, FL
  • NPI 1255688065
  NPD (past)

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1609012632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 W 49TH ST STE 1484",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122957",
            "telephone_number": "305-828-7779",
            "fax_number": "305-828-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 W 49TH ST STE 1484",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122957",
            "telephone_number": "305-828-7779",
            "fax_number": "305-828-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTLAND MALL DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-828-7779",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Regional Center, Inc
• West Technical Service Center Inc
• Westcare Health Center Corp
• Kimberly Westerfield, PTA
• Western Quality Group
• Westland Medical Center HMO Inc
• Westland Medical Equipment Corp
• Westland Pediatrics
• Westland Pharmacy Inc
• Westland Rehabilitation Center Inc

• General Practice Dentistry in Hialeah, FL
• Providers in Hialeah, 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 Dec 3, 2018; 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.