Active NPI
Richard David Siegel, D.D.S.
- Dentist
- Pembroke Pines, FL
National Provider Identifier
1053368282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5054
- Practice address
- 15833 Pines Blvd
Pembroke Pines, FL 33027-1203 - Phone
- (954) 443-3030
- Fax
- (954) 443-9431
- NPI assigned
- May 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 5054 | FL | Primary |
Addresses
Primary practice location
15833 Pines Blvd
Pembroke Pines, FL 33027-1203
Mailing address
15833 Pines Blvd
Pembroke Pines, FL 33027-1203
Phone (954) 443-3030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5054 | Other | FL | DENTAL LICENCE |
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 |
|---|---|---|---|
| 5054 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1053368282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15833 PINES BLVD",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330271203",
"telephone_number": "954-443-3030",
"fax_number": "954-443-9431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15833 PINES BLVD",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330271203",
"telephone_number": "954-443-3030",
"fax_number": "954-443-9431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGEL",
"first_name": "RICHARD",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "5054",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENCE",
"identifier": "5054",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.