Individual provider Active NPI

Maidelys Valdes

  • Dentist
  • Weston, FL
National Provider Identifier
1932972122
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28498 Issued in FL
Practice address
280 Indian Trce Ste a
Weston, FL 33326-4509
Phone
(954) 248-2895
NPI assigned
Oct 31, 2023
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28498 FL Primary

Addresses

Primary practice location

280 Indian Trce Ste a
Weston, FL 33326-4509

Mailing address

5701 W 25TH CT Apt 306
Hialeah, FL 33016-4443
Phone (786) 317-3537

Other practice location 1

240 S 40th St
Philadelphia, PA 19104-6030
Phone (215) 898-8965

Other practice location 2

18312 Pines Blvd
Pembroke Pines, FL 33029-1412
Phone (786) 204-0713

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
I20240528002055 FL Order and Referring Only - DentistPractitioner - Dentist 9032551676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28498FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Pines Modern Dentistry, PA Dentist Past Accepting new patients
Weston Modern Dentistry, PA PastSince Feb 25, 2024 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1932972122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W 25TH CT APT 306",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330164443",
            "telephone_number": "786-317-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 INDIAN TRCE STE A",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333264509",
            "telephone_number": "954-248-2895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 S 40th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191046030",
            "country_code": "US",
            "telephone_number": "215-898-8965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18312 Pines Blvd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330291412",
            "country_code": "US",
            "telephone_number": "786-204-0713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDES",
        "first_name": "MAIDELYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "28498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.