Active NPI
Nancy Medina, DMD
- Endodontics
- Miramar, FL
National Provider Identifier
1710994934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN17634
- Practice address
- 2905 SW 160TH Ave
Miramar, FL 33027-4212 - Phone
- (954) 392-7051
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN17634 | FL | Primary |
Addresses
Primary practice location
2905 SW 160TH Ave
Miramar, FL 33027-4212
Mailing address
3370 NE 190TH St Apt 2807
Aventura, FL 33180-2465
Phone (305) 333-0370
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN17634 | FL | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Water Tower Endodontics, LTD. | Past | 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.
-
- Dental Clinic/Center
- Chicago, IL
- NPI 1326451691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1710994934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3370 NE 190TH ST APT 2807",
"city": "AVENTURA",
"state": "FL",
"postal_code": "331802465",
"telephone_number": "305-333-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 SW 160TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274212",
"telephone_number": "954-392-7051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "NANCY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN17634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.