Healthcare Provider Details

I. General information

NPI: 1326727389
Provider Name (Legal Business Name): BERNARDO ASSUMPCAO CALDAS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15795 SW 152ND ST
MIAMI FL
33187-5417
US

IV. Provider business mailing address

2564 JARDIN DR
WESTON FL
33327-1516
US

V. Phone/Fax

Practice location:
  • Phone: 305-547-8390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI03112800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN27946
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: