Individual provider Active NPI

Maidelys Oliva, DMD

  • Pediatric Dentistry
  • Miami Lakes, FL
National Provider Identifier
1730597253
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN20836 Issued in FL
Practice address
7920 Miami Lakes Drive West
Suite 120
Miami Lakes, FL 33016
Phone
(305) 424-7588
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN20836 FL Primary

Addresses

Primary practice location

7920 Miami Lakes Drive West
Suite 120
Miami Lakes, FL 33016

Mailing address

7920 Miami Lakes Drive West
Suite 120
Miami Lakes, FL 33016

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
I20151112001792 FL Order and Referring Only - DentistPractitioner - Dentist 5395055842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maidelys Oliva DMD PA Pediatric Dentistry CurrentSince Aug 27, 2023 Accepting new patients
Dentaland PA PastSince Jan 1, 2022 Accepting new patients

Locations

7920 Miami Lakes Dr W
Ste 120
Miami Lakes, FL 33016
Phone (305) 424-7588

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1730597253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 MIAMI LAKES DRIVE WEST",
            "address_2": "SUITE 120",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 MIAMI LAKES DRIVE WEST",
            "address_2": "SUITE 120",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33016",
            "telephone_number": "305-424-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "MAIDELYS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN20836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.