Healthcare Provider Details

I. General information

NPI: 1346755303
Provider Name (Legal Business Name): JGS DENTISTRY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 12/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SW 92ND ST STE 103
MIAMI FL
33156-7379
US

IV. Provider business mailing address

8500 SW 92ND ST STE 103
MIAMI FL
33156-7379
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-0861
  • Fax: 305-271-9761
Mailing address:
  • Phone: 305-271-0861
  • Fax: 305-271-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN19105
License Number StateFL

VIII. Authorized Official

Name: DR. PATRICIA H RAMIREZ
Title or Position: PRESIDENT
Credential: DMD
Phone: 305-271-0861