Individual provider Active NPI

Irving Nicolas Carvajal, DDS

  • Dentist
  • Miami, FL
National Provider Identifier
1689716433
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN9565 Issued in FL
Practice address
10114 SW 107 Ave
Miami, FL 33176
Phone
(305) 273-1648
Fax
(305) 273-9589
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN9565 FL Primary

Addresses

Primary practice location

10114 SW 107 Ave
Miami, FL 33176

Mailing address

10114 SW 107 Ave
Miami, FL 33176
Phone (305) 273-1648

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
I20170426000589 FL Order and Referring Only - DentistPractitioner - Dentist 7810274057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1689716433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10114 SW 107 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33176",
            "telephone_number": "305-273-1648",
            "fax_number": "305-273-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10114 SW 107 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33176",
            "telephone_number": "305-273-1648",
            "fax_number": "305-273-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL",
        "first_name": "IRVING",
        "middle_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN9565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.