Theoral Health Institute

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN20850 Issued in FL

Legal business name

THEORAL HEALTH INSTITUTE

Practice address

910 SW 15TH St
Deerfield Beach, FL 33441-6222

Phone

(312) 925-0042

NPI assigned

Nov 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jason Korkus, D.D.S.

Title

Board Member

Phone

(312) 925-0042

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447632000000",
    "number": "1255705273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 GREENLEAF AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221765",
            "telephone_number": "312-925-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SW 15TH ST",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334416222",
            "telephone_number": "312-925-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEORAL HEALTH INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A",
        "authorized_official_last_name": "KORKUS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "312-925-0042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN20850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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