Individual provider Active NPI

Steven M Gilson, DMD

  • General Practice Dentistry
  • Plantation, FL
National Provider Identifier
1063554764
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0009853 Issued in FL
Practice address
1127 S University Dr
Plantation, FL 33324-3322
Phone
(954) 424-4600
Fax
(954) 424-4339
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN0009853 FL Primary

Addresses

Primary practice location

1127 S University Dr
Plantation, FL 33324-3322

Mailing address

12160 SW 2ND St
Plantation, FL 33325-2830
Phone (954) 476-0794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181108002638 FL Order and Referring Only - DentistPractitioner - Dentist 7911251079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0009853FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063554764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12160 SW 2ND ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333252830",
            "telephone_number": "954-476-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 S UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243322",
            "telephone_number": "954-424-4600",
            "fax_number": "954-424-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILSON",
        "first_name": "STEVEN",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0009853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.