NPIMap

Organization Active NPI

Elitedent Corporation

  • Dental Clinic/Center
  • Miami, FL
National Provider Identifier
1861888976
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN17602 Issued in FL
Legal business name
ELITEDENT CORPORATION
Practice address
12538 SW 120TH St
Miami, FL 33186-9064
Phone
(305) 646-6700
NPI assigned
Apr 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Authorized official

Name
Mrs. Jacqueline CorreaNPI 1053516732
Title
D.M.D
Phone
(305) 646-6700

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
Dental Clinic/Center 261QD0000X DN17602 FL Primary

Addresses

Primary practice location

12538 SW 120TH St
Miami, FL 33186-9064

Mailing address

12538 SW 120TH St
Miami, FL 33186-9064
Phone (305) 646-6700

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1861888976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12538 SW 120TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331869064",
            "telephone_number": "305-646-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12538 SW 120TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331869064",
            "telephone_number": "305-646-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITEDENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "D.M.D",
        "authorized_official_telephone_number": "305-646-6700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN17602",
            "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 Apr 15, 2015; 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.