Individual provider Active NPI

Christopher Devilliers

  • General Practice Dentistry
  • Hollywood, FL
National Provider Identifier
1053983262
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25913 Issued in FL
Practice address
2 Oakwood Blvd Ste 150-a
Hollywood, FL 33020-1960
Phone
(954) 367-7088
NPI assigned
Jul 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25913 FL Primary

Addresses

Primary practice location

2 Oakwood Blvd Ste 150-a
Hollywood, FL 33020-1960

Mailing address

2741 SW 117TH Ave
Davie, FL 33330-1431
Phone (305) 431-7036

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

LicenseStateTypeSpecialty
25913FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Magic Touch Dentistry, P.a. General Practice CurrentSince Jul 25, 2021 Accepting new patients
Aca 3Dental, PA General Practice Current Accepting new patients

Locations

2 Oakwood Blvd
Ste 150A
Hollywood, FL 33020
Phone (954) 367-7088

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1053983262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 SW 117TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333301431",
            "telephone_number": "305-431-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OAKWOOD BLVD STE 150-A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201960",
            "telephone_number": "954-367-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVILLIERS",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "25913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.