Individual provider Active NPI

Luisa Yamisel Corrales-Iglesias, DDS

  • General Practice Dentistry
  • Miami Gardens, FL
National Provider Identifier
1861546277
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 17100 Issued in FL
Practice address
4538 NW 183Rd St
Miami Gardens, FL 33055-3045
Phone
(305) 625-8272
Fax
(305) 625-8271
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 17100 FL Primary

Addresses

Primary practice location

4538 NW 183Rd St
Miami Gardens, FL 33055-3045

Mailing address

4538 NW 183Rd St
Miami Gardens, FL 33055-3045
Phone (305) 625-8272

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
I20160614002643 FL Order and Referring Only - DentistPractitioner - Dentist 8820389208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 17100FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Luisa Y. Corrales Iglesias D.D.S, PA. General Practice Current Accepting new patients
Pro Dental Centers West Hialeah General Practice Current Accepting new patients
Miami Gardens Dental,Inc General Practice Past Accepting new patients

Organizations & group practices 3

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1861546277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4538 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330553045",
            "telephone_number": "305-625-8272",
            "fax_number": "305-625-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4538 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330553045",
            "telephone_number": "305-625-8272",
            "fax_number": "305-625-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES-IGLESIAS",
        "first_name": "LUISA",
        "middle_name": "YAMISEL",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 17100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.