Individual provider Active NPI

Ginette Him-Cerrud, DDS

  • Dentist
  • Miami Beach, FL
National Provider Identifier
1720093412
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0012873 Issued in FL
Practice address
710 Alton Rd
Miami Beach, FL 33139-5504
Phone
(305) 538-8835
Fax
(305) 532-5766
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN0012873 FL Primary

Addresses

Primary practice location

710 Alton Rd
Miami Beach, FL 33139-5504

Mailing address

710 Alton Rd
Miami Beach, FL 33139-5504
Phone (305) 538-8835

Other identifiers 2

IdentifierTypeStateIssuer
071724000MedicaidFL
DN0012873OtherFLDENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617002349 FL Order and Referring Only - DentistPractitioner - Dentist 5496066417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0012873FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1720093412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331395504",
            "telephone_number": "305-538-8835",
            "fax_number": "305-532-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331395504",
            "telephone_number": "305-538-8835",
            "fax_number": "305-532-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIM-CERRUD",
        "first_name": "GINETTE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0012873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071724000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DN0012873",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.