Southdade Family Dentisry

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SOUTHDADE FAMILY DENTISRY

Practice address

18543 S Dixie Hwy
Cutler Bay, FL 33157-6815

Phone

(305) 259-9130

Fax

(305) 259-9120

NPI assigned

Aug 28, 2007

Organization subpart

No

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

Authorized official

Name

Alfredo Domingo Corpas, DDS

Title

Owner/Dentist

Phone

(305) 259-9130

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Alfredo Corpas Doing business as

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1881888469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18543 S DIXIE HWY",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576845",
            "telephone_number": "305-259-9130",
            "fax_number": "305-259-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18543 S DIXIE HWY",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576815",
            "telephone_number": "305-259-9130",
            "fax_number": "305-259-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHDADE FAMILY DENTISRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "CORPAS",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_middle_name": "DOMINGO",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "305-259-9130",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074855203",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Alfredo Corpas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• South Florida Vision Services, Inc.
• South Group Ymg Corp.
• Southland Mall Dental
• Southland Mall Dental,P.a.
• Southland Medical Supply, Inc.
• Elbydia Souverain, LCSW
• Speech Problem Solved Inc

• Dentist in Cutler Bay, FL
• Providers in Cutler Bay, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; 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.