Individual provider Active NPI

Ivette Delgado Rey

  • Dentist
  • Miami, FL
National Provider Identifier
1679097869
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22964 Issued in FL
Practice address
430 SW 89TH Ave
Miami, FL 33174-2435
Phone
(786) 230-7249
Fax
(786) 230-7249
NPI assigned
Jul 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22964 FL Primary

Addresses

Primary practice location

430 SW 89TH Ave
Miami, FL 33174-2435

Mailing address

430 SW 89TH Ave
Miami, FL 33174-2435
Phone (305) 323-2445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190507001561 FL Practitioner - Oral SurgeryPractitioner - Dentist 7810239175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22964FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1679097869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 SW 89TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331742435",
            "telephone_number": "305-323-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 SW 89TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331742435",
            "telephone_number": "786-230-7249",
            "fax_number": "786-230-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO REY",
        "first_name": "IVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "22964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.