William a. Pena DMD, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN17608 Issued in FL

Legal business name

WILLIAM A. PENA DMD, PA

Doing business as

American Pediatric Dental Group

Practice address

10021 Pines Blvd
Suite 100
Pembroke Pines, FL 33024-6191

Phone

(954) 417-1337

Fax

(954) 417-1338

NPI assigned

Jun 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. William Antonio Pena, DMD, MS, MBA

Title

Owner/President

Phone

(415) 216-6649

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• American Pediatric Dental Group Doing business as

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1720374838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 PINES BLVD",
            "address_2": "SUITE 100",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246191",
            "telephone_number": "954-417-1337",
            "fax_number": "954-417-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 PINES BLVD",
            "address_2": "SUITE 100",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246191",
            "telephone_number": "954-417-1337",
            "fax_number": "954-417-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM A. PENA DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "415-216-6649",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS, MBA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000641100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Pediatric Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Whole Life Distributors (companions 4 life)
• Nicole Wiedeke
• Susana Wilhelm, D.D.S
• Alsia Barbara Wilkinson
• Carole L Wilkinson, ARNP, MHPNP
• William H Myones DMD PA (Periodontics and Oral Implantology Center of South Florida)
• William Pena MD LLC
• William R Alexis MD PA (Florida Cardiovascular Associates)
• Wilma Joy Williams-Blake, ARNP
• Aaron Elijah Williams

• Pediatric Dentistry in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.