Supreme Dental Care LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUPREME DENTAL CARE LLC

Practice address

4600 W Commercial Blvd Ste 2
Tamarac, FL 33319-3307

Phone

(954) 742-3550

NPI assigned

Feb 3, 2023

Organization subpart

No

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

Authorized official

Name

Sergio Jacas, DMDNPI 1184004228

Title

Owner

Phone

(954) 742-3550

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sergio Julio Jacas, D.M.D

  • Dentist
  • Fort Lauderdale, FL
  • NPI 1184004228
  NPD Authorized official
• Robert Stanley Frankel, D.M.D.

  • General Practice Dentistry
  • Lauderhill, FL
  • NPI 1609934991
  NPD (past)
• Jose Carlos Jacas, DMD

  • General Practice Dentistry
  • Tampa, FL
  • NPI 1669032603
  NPD (past)

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1104522812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 W OAKLAND PARK BLVD STE 301",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333131016",
            "telephone_number": "954-742-3550",
            "fax_number": "954-741-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 W COMMERCIAL BLVD STE 2",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333193307",
            "telephone_number": "954-742-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "JACAS",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-742-3550",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Tamarac, FL
• Providers in Tamarac, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.