Individual provider Active NPI

Johanna Gallego-Eckstein

  • General Practice Dentistry
  • North Miami Beach, FL
National Provider Identifier
1639484686
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20453 Issued in FL
Practice address
3031 NE 163Rd St
North Miami Beach, FL 33160-4462
Phone
(305) 945-0909
NPI assigned
Aug 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 20453 FL
General Practice Dentistry 1223G0001X 20453 FL Primary

Addresses

Primary practice location

3031 NE 163Rd St
North Miami Beach, FL 33160-4462

Mailing address

1914 NE 204TH Ter
Miami, FL 33179-2250
Phone (954) 682-9303

Other practice location 1

4757 S University Dr
Davie, FL 33328-3819
Phone (954) 434-3331

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
20453FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eli Abbo DMD PA CurrentSince Jun 3, 2025 Accepting new patients
Davie Advanced Dentistry General Practice PastSince May 18, 2025 Accepting new patients
Luis F Mota DMD Ms PA PastSince Mar 24, 2025 Accepting new patients
Claudia a Draizin DMD PA General Practice Past Accepting new patients

Locations

3031 NE 163rd St
North Miami Beach, FL 33160
Phone (305) 945-0909

Organizations & group practices 4

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": "1281830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1639484686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 NE 204TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792250",
            "telephone_number": "954-682-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331604462",
            "telephone_number": "305-945-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4757 S University Dr",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333283819",
            "country_code": "US",
            "telephone_number": "954-434-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGO-ECKSTEIN",
        "first_name": "JOHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-15",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "20453",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "20453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.