NPIMap

Organization Active NPI

Nicomedes Berasain, DDS, PA

  • Dentist
  • Miami, FL
National Provider Identifier
1831395763
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN007985 Issued in FL
Legal business name
NICOMEDES BERASAIN, DDS, PA
Practice address
300 SW 107TH Ave
Suite 203
Miami, FL 33174-3600
Phone
(305) 551-6866
Fax
(305) 551-2863
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Authorized official

Name
Dr. Nicomedes Berasain, DDSNPI 1164598702
Title
President
Phone
(305) 551-6866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN007985 FL Primary

Addresses

Primary practice location

300 SW 107TH Ave
Suite 203
Miami, FL 33174-3600

Mailing address

300 SW 107TH Ave
Suite 203
Miami, FL 33174-3600
Phone (305) 551-6866

National Provider Directory

National Provider Directory

Locations

300 SW 107th Ave
Ste 203
Miami, FL 33174
Phone (305) 551-6866

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1831395763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SW 107TH AVE",
            "address_2": "SUITE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743600",
            "telephone_number": "305-551-6866",
            "fax_number": "305-551-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SW 107TH AVE",
            "address_2": "SUITE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743600",
            "telephone_number": "305-551-6866",
            "fax_number": "305-551-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOMEDES BERASAIN, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "BERASAIN",
        "authorized_official_first_name": "NICOMEDES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-551-6866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN007985",
            "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 Aug 7, 2008; 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.