Doral Pediatric Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DORAL PEDIATRIC DENTISTRY, LLC

Practice address

10717 NW 58TH St
Doral, FL 33178-2801

Phone

(305) 513-4058

Fax

(305) 639-2931

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Juan Luis Garrastazu, DMDNPI 1043382138

Title

President

Phone

(305) 513-4058

Specialties & licenses 1

Addresses

Tax ID family

Doral Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Doral Pediatric Dentistry

  • Dentist
  • Miami, FL
  • NPI 1437603446
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Doral Pediatric Dentistry

  • Dentist
  • Miami, FL
  • NPI 1437603446
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Juan Luis Garrastazu, D.M.D.

  • Dentist
  • Doral, FL
  • NPI 1043382138
  NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1720202815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 NW 58TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782801",
            "telephone_number": "305-513-4058",
            "fax_number": "305-639-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10717 NW 58TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782801",
            "telephone_number": "305-513-4058",
            "fax_number": "305-639-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORAL PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "GARRASTAZU",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-513-4058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doral Medical Office Corp
• Doral Medical Rehab Center Inc
• Doral Medicine Associates Inc.
• Doral Oriental Medicine Center
• Doral Outpatient Physicians, Inc.
• Doral Pediatrics P.a.
• Doral Physical Therapy L.L.C.
• Doral Physiotherapy, PLLC
• Doral Recovery Center, Inc
• Doral Rehab and Fitness Center Inc

• Pediatric Dentistry in Doral, FL
• Providers in Doral, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.