NPIMap

Organization Active NPI

West Pines Modern Dentistry, PA

Doing business as West Pines Modern Dentistry

  • Dentist
  • Pembroke Pines, FL
National Provider Identifier
1134654064
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WEST PINES MODERN DENTISTRY, PA
Doing business as
West Pines Modern Dentistry
Practice address
18312 Pines Blvd
Pembroke Pines, FL 33029-1412
Phone
(786) 204-0713
Fax
(786) 204-0714
NPI assigned
Apr 28, 2017
Last updated
Apr 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Authorized official

Name
Katie McCann
Title
Owner
Phone
(786) 204-0713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

18312 Pines Blvd
Pembroke Pines, FL 33029-1412

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • West Pines Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

18312 Pines Blvd
Pembroke Pines, FL 33029
Phone (786) 204-0713

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1134654064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18312 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291412",
            "telephone_number": "786-204-0713",
            "fax_number": "786-204-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PINES MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-204-0713"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Pines Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.