NPIMap

Organization Active NPI

Dental Las Olas PA

  • Dentist
  • Fort Lauderdale, FL
National Provider Identifier
1265862593
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20436 Issued in FL
Legal business name
DENTAL LAS OLAS PA
Practice address
401 E Las Olas Blvd
Suite #140
Fort Lauderdale, FL 33301-2210
Phone
(954) 524-6595
NPI assigned
Nov 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Authorized official

Name
Dr. Nadezda Selmic, DMDNPI 1861608218
Title
President
Phone
(617) 818-4596

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 20436 FL Primary

Addresses

Primary practice location

401 E Las Olas Blvd
Suite #140
Fort Lauderdale, FL 33301-2210

Mailing address

900 NE 12TH Ave
Apt 602
Hallandale Beach, FL 33009-2655
Phone (617) 818-4596

National Provider Directory

National Provider Directory

Locations

401 E Las Olas Blvd
Ste 140
Ft Lauderdale, FL 33301
Phone (617) 818-4596

Practitioners & affiliated clinicians

Practitioners 2

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": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1265862593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NE 12TH AVE",
            "address_2": "APT 602",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330092655",
            "telephone_number": "617-818-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E LAS OLAS BLVD",
            "address_2": "SUITE #140",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012210",
            "telephone_number": "954-524-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL LAS OLAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "SELMIC",
        "authorized_official_first_name": "NADEZDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-818-4596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "20436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.