Active NPI
Jeffrey Howard Nullman, DDS PA
- General Practice Dentistry
- Miami, FL
National Provider Identifier
1093808263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7317
- Practice address
- 11467 SW 40TH St
Miami, FL 33165 - Phone
- (305) 552-7050
- Fax
- (305) 553-3562
- NPI assigned
- Oct 2, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7317 | FL | Primary |
Addresses
Primary practice location
11467 SW 40TH St
Miami, FL 33165
Mailing address
11467 SW 40TH St
Miami, FL 33165
Phone (305) 552-7050
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7317 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Country Community Health | Past | Accepting new patients | |
| Comfortable Care Dental Health Professionals, P.a. | General Practice | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJJEBD
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.
-
- General Practice Dentistry
- Miami, FL
- NPI 1629558648
-
- Federally Qualified Health Center (FQHC)
- Newland, NC
- NPI 1083979082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093808263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11467 SW 40TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "33165",
"telephone_number": "305-552-7050",
"fax_number": "305-553-3562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11467 SW 40TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "33165",
"telephone_number": "305-552-7050",
"fax_number": "305-553-3562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NULLMAN",
"first_name": "JEFFREY",
"middle_name": "HOWARD",
"name_prefix": "Dr.",
"credential": "DDS PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "7317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.