Professional Dental Alliance of Homestead, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF HOMESTEAD, PLLC

Practice address

2870 NE 8TH St
Homestead, FL 33033-5695

Phone

(305) 547-8398

NPI assigned

Feb 22, 2019

Last updated

Feb 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren Howard, MA

Title

Credentialing Specialist

Phone

(724) 698-2029

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1699232942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 NE 8TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335695",
            "telephone_number": "305-547-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF HOMESTEAD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "724-698-2029",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Private Circle Care LLC
• Procare Orthopedics, Inc
• Procare Orthopedics, Inc
• Professional Ba Skills LLC
• Professional Dental Alliance of Homestead Ortho, PLLC
• Professional Hands Rehabilitation Center Corp
• Professional Medical Equipment & Supply Inc
• Professional Nurse Practitioner Inc
• Professional Services Care Inc.
• Professional TCM & Behavioral Analyst Services Corp

• Dentist in Homestead, FL
• Providers in Homestead, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.