Primary Dental Partners PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PRIMARY DENTAL PARTNERS PA

Practice address

3039 Johnson Street
Hollywood, FL 33021

Phone

(954) 399-8039

NPI assigned

Apr 28, 2021

Last updated

Sep 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eyad Shehadeh, DDS

Title

Director

Phone

(954) 399-8039

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1114509171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3039 JOHNSON STREET",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-399-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3039 JOHNSON STREET",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-399-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY DENTAL PARTNERS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2023-09-25",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "SHEHADEH",
        "authorized_official_first_name": "EYAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-399-8039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary Care Medical Services
• Primary Care Physicians of Hollywood, PA
• Primary Care Physicians of Hollywood, PL
• Primary Care Physicians of Hollywood, PL
• Primary Care Physicins of Hollywood PA (PCP RX Direct)
• Primary Diagnostics Laboratory PLLC
• Primary Medical Physicians, LLC
• Primary Medical Physicians, LLC
• Prime Pediatric Dental Group PA
• Prince Adam's Place

• General Practice Dentistry in Hollywood, FL
• Providers in Hollywood, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.