NPI 1073002259 · live from the CMS NPI Registry
1500 Dental LLC
Dentist, Periodontics in Fort Lauderdale, FL. National Provider Identifier 1073002259, active.
NPI record
| NPI | 1073002259 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Periodontics 1223P0300X |
| Practice location | 1500 N Federal Hwy Ste 250, Fort Lauderdale, FL 33304 |
| Practice phone | 954-715-1000 |
| Enumerated | May 3, 2018 |
| Last updated | May 3, 2018 |
| Authorized official | Nekelda Weiss, Insurance & Credentialing Coordinat |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | DN14284 (FL) |
| Dentist, Periodontics primary | 1223P0300X | DN16336 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.