Active NPI
Shiva Khatami, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Davie, FL
National Provider Identifier
1013219922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DTP533
- Practice address
- 3200 S University Dr
Davie, FL 33328-2018 - Phone
- (954) 262-7500
- Fax
- (954) 262-7164
- NPI assigned
- Nov 29, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DTP533 | FL | Primary |
Addresses
Primary practice location
3200 S University Dr
Davie, FL 33328-2018
Mailing address
110 N Federal Hwy
Apt # 813
Ft Lauderdale, FL 33301-1180
Phone (954) 632-7884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DTP533 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1013219922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 N FEDERAL HWY",
"address_2": "APT # 813",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333011180",
"telephone_number": "954-632-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282018",
"telephone_number": "954-262-7500",
"fax_number": "954-262-7164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHATAMI",
"first_name": "SHIVA",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-29",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DTP533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.