Individual provider Active NPI

Jordan Michael Kaltman, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Davie, FL
National Provider Identifier
1063709780
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN17969 Issued in FL
Practice address
3200 S University Dr
Davie, FL 33328-2018
Phone
(954) 262-1680
NPI assigned
Jul 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN17969 FL Primary

Addresses

Primary practice location

3200 S University Dr
Davie, FL 33328-2018

Mailing address

3200 S University Dr
Davie, FL 33328-2018
Phone (954) 262-1680

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120222001004 FL Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 1254599194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Nova Southeastern Univ College of Dental Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Strauss and Strauss D.M.D.S, PAGroup PAC ID 2769462969, 5 clinicians

Practice addresses (Care Compare)

821 E Ocean Blvd
Suite a
Stuart, FL 34994-2456
Phone (772) 283-6757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strauss & Strauss D.M.D.S, PA Oral and Maxillofacial Surgery CurrentSince Jan 1, 2015 Accepting new patients

Locations

1601 SW Gatlin Blvd
Port St Lucie, FL 34953
Phone (772) 785-7327

1801 SE Hillmoor Dr
Ste A-106
Port St Lucie, FL 34952
Phone (772) 335-5090

821 SE Ocean Blvd
Ste A
Stuart, FL 34994
Phone (407) 283-6757

Organizations & group practices 1

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1063709780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALTMAN",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN17969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.