Provider Demographics
NPI:1336160910
Name:JUAN C. BIRD DMD PA
Entity Type:Organization
Organization Name:JUAN C. BIRD DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-386-2713
Mailing Address - Street 1:10249 SW 162ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5892
Mailing Address - Country:US
Mailing Address - Phone:305-386-2713
Mailing Address - Fax:
Practice Address - Street 1:401 MIRACLE MILE
Practice Address - Street 2:STE 411
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4926
Practice Address - Country:US
Practice Address - Phone:305-648-9190
Practice Address - Fax:305-648-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty