NPIMap

Organization Active NPI

Ilya P Freyberg DDS PA

  • Dental Clinic/Center
  • Hollywood, FL
National Provider Identifier
1245737014
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ILYA P FREYBERG DDS PA
Practice address
1876 Polk St
Hollywood, FL 33020-3335
Phone
(917) 519-3772
NPI assigned
Apr 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Authorized official

Name
Ilya Freyberg, DDSNPI 1841345485
Title
President
Phone
(917) 519-3772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1876 Polk St
Hollywood, FL 33020-3335

Mailing address

1876 Polk St
Hollywood, FL 33020-3335

Other practice location 1

210 174th St Apt M14
Sunny Isles Beach, FL 33160-3335
Phone (917) 519-3772

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1245737014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1876 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203335",
            "telephone_number": "917-519-3772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 174th St Apt M14",
            "address_purpose": "LOCATION",
            "city": "Sunny Isles Beach",
            "state": "FL",
            "postal_code": "331603335",
            "country_code": "US",
            "telephone_number": "917-519-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ILYA P FREYBERG DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "FREYBERG",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-519-3772",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.