Active NPI
Prime Pediatric Dental Group PA
- Pediatric Dentistry
- Hialeah, FL
National Provider Identifier
1730906124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- PRIME PEDIATRIC DENTAL GROUP PA
- Practice address
- 4410 W 16TH Ave Ste 52
Hialeah, FL 33012-7193 - Phone
- (305) 251-5390
- NPI assigned
- Sep 25, 2024
- Organization subpart
- Yes
- Parent organization
- PRIME PEDIATRIC DENTAL GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jose Mellado, DMD
- Title
- President
- Phone
- (305) 321-3790
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
4410 W 16TH Ave Ste 52
Hialeah, FL 33012-7193
Mailing address
4410 W 16TH Ave Ste 52
Hialeah, FL 33012-7193
National Provider Directory
National Provider Directory- Part of
- Prime Pediatric Dental Group PA
Locations
4410 W 16th Ave
Ste 52
Hialeah, FL 33012
Phone (305) 321-3790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727654400000",
"number": "1730906124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4410 W 16TH AVE STE 52",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330127193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 W 16TH AVE STE 52",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330127193",
"telephone_number": "305-251-5390"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIME PEDIATRIC DENTAL GROUP PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PRIME PEDIATRIC DENTAL GROUP",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A",
"authorized_official_last_name": "MELLADO",
"authorized_official_first_name": "JOSE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "305-321-3790",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.