NPIMap

Organization Active NPI

Prime Pediatric Dental Group PA

  • Pediatric Dentistry
  • Coral Springs, FL
National Provider Identifier
1760355325
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PRIME PEDIATRIC DENTAL GROUP PA
Practice address
9156 Wiles Rd
Coral Springs, FL 33067-1999
Phone
(954) 621-2115
NPI assigned
Sep 29, 2025
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Jose I Delgado, PHD
Title
Advisor
Phone
(904) 806-7080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

9156 Wiles Rd
Coral Springs, FL 33067-1999

Mailing address

13195 Biscayne Bay Dr
North Miami, FL 33181-2204

National Provider Directory

National Provider Directory
Tax ID family
Prime Pediatric Dental Group PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1760355325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 BISCAYNE BAY DR",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331812204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9156 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330671999",
            "telephone_number": "954-621-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PEDIATRIC DENTAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADVISOR",
        "authorized_official_telephone_number": "904-806-7080",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.