Dr.Otero Dental Center, PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR.OTERO DENTAL CENTER, PA

Practice address

1140 W 49 Street
Hialeah, FL 33012-3148

Phone

(305) 819-0008

Fax

(786) 518-2733

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Antonio Otero, DDS

Title

President

Phone

(305) 819-0008

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1710199203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W 49 STREET",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123148",
            "telephone_number": "305-819-0008",
            "fax_number": "786-518-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W 49 STREET",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123148",
            "telephone_number": "305-819-0008",
            "fax_number": "786-518-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.OTERO DENTAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "OTERO",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-819-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077828102",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.