NPIMap

Organization Active NPI

Marisabel Olivera, DMD, PA

  • Pediatric Dentistry
  • Fort Lauderdale, FL
National Provider Identifier
1013446301
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN18784 Issued in FL
Legal business name
MARISABEL OLIVERA, DMD, PA
Practice address
2022 NE 18TH St
Fort Lauderdale, FL 33305-2508
Phone
(954) 727-9865
NPI assigned
Jun 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Marisabel Olivera, DMDNPI 1750674891
Title
DMD/Owner
Phone
(954) 727-9865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DN18784 FL Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

2022 NE 18TH St
Fort Lauderdale, FL 33305-2508

Mailing address

2022 NE 18TH St
Fort Lauderdale, FL 33305-2508
Phone (954) 727-9865

Other practice location 1

4800 NE 20th Terrace
Suite 301 S
Fort Lauderdale, FL 33308
Phone (954) 727-9865

National Provider Directory

National Provider Directory

Locations

4800 NE 20th Ter
Ste 301S
Fort Lauderdale, FL 33308

4800 NE 20th Ter
Ste 301
Fort Lauderdale, FL 33308
Phone (954) 727-9865

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013446301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 NE 18TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052508",
            "telephone_number": "954-727-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 NE 18TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052508",
            "telephone_number": "954-727-9865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 NE 20th Terrace",
            "address_2": "Suite 301 S",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "33308",
            "country_code": "US",
            "telephone_number": "954-727-9865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARISABEL OLIVERA, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "OLIVERA",
        "authorized_official_first_name": "MARISABEL",
        "authorized_official_title_or_position": "DMD/OWNER",
        "authorized_official_telephone_number": "954-727-9865",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN18784",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.