Nicholas John Savastano, Jr. Jr., D.M.D., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN15487 Issued in FL

Practice address

4362 Northlake Blvd Ste 114
Palm Beach Gardens, FL 33410-6269

Phone

(561) 658-4100

Fax

(866) 333-2309

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Nick J Savastano Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1154348233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4362 NORTHLAKE BLVD STE 114",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106269",
            "telephone_number": "561-658-4100",
            "fax_number": "866-333-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4362 NORTHLAKE BLVD STE 114",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106269",
            "telephone_number": "561-658-4100",
            "fax_number": "866-333-2309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 Savannah Hwy",
            "address_2": "Unit # 107b",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294077859",
            "country_code": "US",
            "telephone_number": "843-642-8100",
            "fax_number": "843-566-0706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAVASTANO, JR.",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "DGD 8789 DS",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN15487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105737100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX8789",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICK",
            "last_name": "SAVASTANO",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "D.M.D., M.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Colleen Meghan Sarrazin, M.S., CCC-SLP
• Nicolette Sas
• Saul Lipsman DPM MD PA
• Jon Saul, PT, DPT, ATC
• Joseph Anthony Savarese II, M.D.
• Philip Albert Saville, MD
• Michael J Savoia, DDS
• Ingrid Savola
• Paul Sawala, DC
• Michael D Sawney

• Orthodontics and Dentofacial Orthopedics Dentistry in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.