Individual provider Active NPI

Mileidis Pena Marro, DMD

  • Dentist
  • Miami, FL
National Provider Identifier
1750730388
Registry record updated Jun 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 21866 Issued in FL
Practice address
13706 SW 56TH St
201
Miami, FL 33175-6036
Phone
(305) 888-0008
NPI assigned
Jun 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 21866 FL Primary

Addresses

Primary practice location

13706 SW 56TH St
201
Miami, FL 33175-6036

Mailing address

13195 SW 19TH Ter
Miami, FL 33175-1311
Phone (305) 281-1093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN 21866FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464998400000",
    "number": "1750730388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 19TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331751311",
            "telephone_number": "305-281-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13706 SW 56TH ST",
            "address_2": "201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756036",
            "telephone_number": "305-888-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA MARRO",
        "first_name": "MILEIDIS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-04",
        "last_updated": "2016-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2016; 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.