1558370791 NPI number — ALDO J BENDANA DDS INC

Table of content: (NPI 1558370791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558370791 NPI number — ALDO J BENDANA DDS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALDO J BENDANA DDS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALDO J BENDANA DDS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558370791
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8500 W FLAGLER ST
Provider Second Line Business Mailing Address:
SUITE # B-205
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33144-2054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-559-5700
Provider Business Mailing Address Fax Number:
305-226-8093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8500 W FLAGLER ST
Provider Second Line Business Practice Location Address:
SUITE # B-205
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33144-2054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-559-5700
Provider Business Practice Location Address Fax Number:
305-226-8093
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BENDANA
Authorized Official First Name:
ALDO
Authorized Official Middle Name:
JOSE
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
305-559-5700

Provider Taxonomy Codes

  • Taxonomy code: 1223E0200X , with the licence number:  DN11931 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 015056 . This is a "DELTA DENTAL PMI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 600035 . This is a "COMPBENEFITS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 699256 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0710164 00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 69172 . This is a "BLUE CROSS& BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5060 . This is a "SASFEGUARD INS." identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 251740 . This is a "CIGNA DENTAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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