Floridian Dental at Palmetto Bay, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN19253 Issued in FL

Legal business name

FLORIDIAN DENTAL AT PALMETTO BAY, LLC

Doing business as

Floridian Dental at Palmetto Bay

Practice address

15801 S Dixie Hwy
Suite B
Palmetto Bay, FL 33157-1837

Phone

(305) 255-4140

Fax

(305) 252-8323

NPI assigned

Dec 12, 2016

Organization subpart

No

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

Authorized official

Name

Elizabeth Heredia

Title

Office Manager

Phone

(305) 255-4140

Specialties & licenses 1

Addresses

Other names 1

• Floridian Dental at Palmetto Bay Doing business as

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1689118523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15801 S DIXIE HWY",
            "address_2": "SUITE B",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571837",
            "telephone_number": "305-255-4140",
            "fax_number": "305-252-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15801 S DIXIE HWY",
            "address_2": "SUITE B",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571837",
            "telephone_number": "305-255-4140",
            "fax_number": "305-252-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDIAN DENTAL AT PALMETTO BAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "HEREDIA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-255-4140"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN19253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Floridian Dental at Palmetto Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.