NPIMap

Organization Active NPI

Pediatric Dental Center of West Kendall Inc

  • Pediatric Dentistry
  • Miami, FL
National Provider Identifier
1689255218
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL CENTER OF WEST KENDALL INC
Practice address
9075 SW 162ND Ave Ste 110&112
Miami, FL 33196-6437
Phone
(954) 513-9277
NPI assigned
Apr 15, 2021
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Enrique Acosta, DDS
Title
President
Phone
(305) 456-8314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

9075 SW 162ND Ave Ste 110&112
Miami, FL 33196-6437

Mailing address

9075 SW 162ND Ave Ste 110&112
Miami, FL 33196-6437
Phone (954) 513-9277

National Provider Directory

National Provider Directory

Locations

9075 SW 162nd Ave
Ste 110112
Miami, FL 33196
Phone (305) 456-8314

Practitioners & affiliated clinicians

Practitioners 8

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": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1689255218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9075 SW 162ND AVE STE 110&112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966437",
            "telephone_number": "954-513-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 SW 162ND AVE STE 110&112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966437",
            "telephone_number": "954-513-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CENTER OF WEST KENDALL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-06-04",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-456-8314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.