Coral Ridge Smile

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CORAL RIDGE SMILE

Practice address

2324 NE 53Rd St
Ft Lauderdale, FL 33308-3212

Phone

(954) 990-6543

Fax

(954) 491-4876

NPI assigned

Apr 2, 2007

Last updated

Feb 16, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

MANDANA INC.As reported in NPPES

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

Authorized official

Name

Dr. Mandana Mir Esmaili, D.D.S.

Title

Owner

Phone

(954) 990-6543

Specialties & licenses 1

Addresses

Part of

Coral Ridge Smile

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1689794505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 NE 53RD ST.",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-990-6543",
            "fax_number": "954-941-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 NE 53RD ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083212",
            "telephone_number": "954-990-6543",
            "fax_number": "954-491-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL RIDGE SMILE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANDANA INC.",
        "enumeration_date": "2007-04-02",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "MIR ESMAILI",
        "authorized_official_first_name": "MANDANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-990-6543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert C. Coppola, O.D.
• Roberto P Coquis Sr., MD
• Coral Ridge Chiroprractic
• Coral Ridge Gastroenterology Associates LLC
• Coral Ridge Pediatrics Inc.
• Michael Andrew Corbin, M.D., L.L.C.
• Jessica Aviva Corcos, M.S, CCC-SLP
• Melissa Lea Corcos, MS, CCC-SLP
• Maria Cordero
• Regine M. Cordon-Shiver, LCSW

• General Practice Dentistry in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.