Individual provider Active NPI

Amanda Vicari

  • General Practice Dentistry
  • Hialeah, FL
National Provider Identifier
1710627146
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DRPM2405 Issued in FL
Practice address
750 E 25TH St
Hialeah, FL 33013
Phone
(305) 694-5400
NPI assigned
Apr 1, 2022
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DRPM2405 FL Primary

Addresses

Primary practice location

750 E 25TH St
Hialeah, FL 33013

Mailing address

2775 NE 187TH St
PH 29
Aventura, FL 33180
Phone (754) 715-5303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DRPM2405FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Associates, Inc General Practice PastSince Apr 17, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1710627146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 NE 187TH ST",
            "address_2": "PH 29",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "754-715-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33013",
            "telephone_number": "305-694-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICARI",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DRPM2405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.