Individual provider Active NPI

Sava Estanboliah

  • General Practice Dentistry
  • Boynton Beach, FL
National Provider Identifier
1235512526
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23707 Issued in FL
Practice address
2623 S Seacrest Blvd Ste 112
Boynton Beach, FL 33435-7531
Phone
(561) 810-8790
NPI assigned
Jul 4, 2015
Last updated
May 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 23707 FL Primary

Addresses

Primary practice location

2623 S Seacrest Blvd Ste 112
Boynton Beach, FL 33435-7531

Mailing address

639 E Ocean Ave Ste 409
Boynton Beach, FL 33435-5017
Phone (561) 735-6553

Other practice location 1

466 SW Port St Lucie Blvd Ste 117
St Lucie West, FL 34953-2091
Phone (772) 785-9515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211027003382 FL Practitioner - Dentist 8527314863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23707FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Community Health Inc CurrentSince Sep 20, 2021 Accepting new patients
Genesis Community Health, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Best HMS, LLC PastSince Aug 26, 2016 Accepting new patients

Locations

600 S Dixie Hwy
Ste 103
Boca Raton, FL 33432
Phone (561) 395-1011

2623 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 735-6553

2623 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 738-9761

709 S Federal Hwy
Ste 3
Boynton Beach, FL 33435
Phone (561) 735-6553

639 E Ocean Ave
Ste 409
Ocean Ridge, FL 33435
Phone (561) 806-6835

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1235512526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 E OCEAN AVE STE 409",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334355017",
            "telephone_number": "561-735-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 S SEACREST BLVD STE 112",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357531",
            "telephone_number": "561-810-8790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "466 SW Port St Lucie Blvd Ste 117",
            "address_purpose": "LOCATION",
            "city": "St Lucie West",
            "state": "FL",
            "postal_code": "349532091",
            "country_code": "US",
            "telephone_number": "772-785-9515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTANBOLIAH",
        "first_name": "SAVA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-04",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "23707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.