Susan Diane Galvis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DTP826 Issued in FL

Practice address

3300 S University Drive
Department of Oral Science and Translational Research
Fort Lauderdale, FL 33328-2018

Phone

(954) 262-7315

Fax

(954) 262-1782

NPI assigned

Dec 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1043979826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S UNIVERSITY DRIVE",
            "address_2": "DEPARTMENT OF ORAL SCIENCE AND TRANSLATIONAL RESEARCH",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-7315",
            "fax_number": "954-262-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S UNIVERSITY DRIVE",
            "address_2": "DEPARTMENT OF ORAL SCIENCE AND TRANSLATIONAL RESEARCH",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-7315",
            "fax_number": "954-262-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVIS",
        "first_name": "SUSAN",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DTP826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.