Individual provider Active NPI

Vadim Valdman, DDS

  • General Practice Dentistry
  • Sunrise, FL
National Provider Identifier
1184860413
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17761 Issued in FL
Practice address
12801 W Sunrise Blvd Ste F222
Sunrise, FL 33323-4020
Phone
(954) 846-7171
Fax
(954) 846-7170
NPI assigned
Dec 16, 2008
Last updated
Dec 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17761 FL Primary

Addresses

Primary practice location

12801 W Sunrise Blvd Ste F222
Sunrise, FL 33323-4020

Mailing address

12801 W Sunrise Blvd Ste F222
Sunrise, FL 33323-4020
Phone (954) 846-7171

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

State licenses

LicenseStateTypeSpecialty
DN17761FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1184860413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12801 W SUNRISE BLVD STE F222",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333234020",
            "telephone_number": "954-846-7171",
            "fax_number": "954-846-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 W SUNRISE BLVD STE F222",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333234020",
            "telephone_number": "954-846-7171",
            "fax_number": "954-846-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDMAN",
        "first_name": "VADIM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.