Active NPI
Elissabet Banega
- Dentist
- Miami, FL
National Provider Identifier
1902636160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN29448
- Practice address
- 750 NW 20TH St BLDG G10
Miami, FL 33127-4618 - Phone
- (305) 363-2222
- NPI assigned
- Aug 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401418868 | VA | |
| Dentist | 122300000X | DN29448 | FL | Primary |
Addresses
Primary practice location
750 NW 20TH St BLDG G10
Miami, FL 33127-4618
Mailing address
750 NW 20TH St BLDG G10
Miami, FL 33127-4618
Phone (305) 363-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN29448 | FL | MD | Dentist |
| 0401418868 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1902636160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 NW 20TH ST BLDG G10",
"city": "MIAMI",
"state": "FL",
"postal_code": "331274618",
"telephone_number": "305-363-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 NW 20TH ST BLDG G10",
"city": "MIAMI",
"state": "FL",
"postal_code": "331274618",
"telephone_number": "305-363-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANEGA",
"first_name": "ELISSABET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-02",
"last_updated": "2024-08-02",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401418868",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN29448",
"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 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.