NPIMap

Organization Active NPI

Deerfield Family Dentistry

  • Dentist
  • Deerfield Beach, FL
National Provider Identifier
1205213741
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN14972 Issued in FL
Legal business name
DEERFIELD FAMILY DENTISTRY
Practice address
1369 S Military Trail
Deerfield Beach, FL 33442
Phone
(954) 480-9488
Fax
(954) 480-9486
NPI assigned
May 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Ilya Stern, DMD
Title
President
Phone
(954) 480-9488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN14972 FL Primary

Addresses

Primary practice location

1369 S Military Trail
Deerfield Beach, FL 33442

Mailing address

1369 S Military Trail
Deerfield Beach, FL 33442
Phone (954) 480-9488

National Provider Directory

National Provider Directory

Locations

1369 S Military Trl
Deerfield Beach, FL 33442
Phone (954) 421-1982

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1205213741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 S MILITARY TRAIL",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "33442",
            "telephone_number": "954-480-9488",
            "fax_number": "954-480-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 S MILITARY TRAIL",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "33442",
            "telephone_number": "954-480-9488",
            "fax_number": "954-480-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERFIELD FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-480-9488",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.