Sedation Dental Spa of South Florida, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

16349 Issued in FL

Legal business name

SEDATION DENTAL SPA OF SOUTH FLORIDA, LLC

Practice address

2028 E Sample Rd
Lighthouse Point, FL 33064-7596

Phone

(954) 946-8484

Fax

(954) 272-7982

NPI assigned

Aug 2, 2018

Organization subpart

Yes

Parent organization

SEDATION DENTAL SPA OF SOUTH FLORIDA LLCAs reported in NPPES

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

Authorized official

Name

Ms. Sally Jane Dunlap

Title

Office Manager

Phone

(954) 946-8484

Specialties & licenses 1

Addresses

Other names 1

• Michael A. Gorman DMD Doing business as

Part of

Sedation Dental Spa of South Florida LLC

Practitioners 2

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

• Dennis Solomon Sevel, D.D.S

  • General Practice Dentistry
  • Miramar, FL
  • NPI 1568665966
  NPD (past)
• Laurence Edward Fendrich, D.M.D.

  • General Practice Dentistry
  • Austin, TX
  • NPI 1457554818
  NPD (past)

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1265910129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 E SAMPLE RD",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647596",
            "telephone_number": "954-946-8484",
            "fax_number": "954-272-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 E SAMPLE RD",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647596",
            "telephone_number": "954-946-8484",
            "fax_number": "954-272-7982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18431 Miramar Pkwy",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295802",
            "country_code": "US",
            "telephone_number": "954-433-4300",
            "fax_number": "954-827-0192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEDATION DENTAL SPA OF SOUTH FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEDATION DENTAL SPA OF SOUTH FLORIDA LLC",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-946-8484",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "16349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael A. Gorman DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Rosin, M.S.
• Terry Alicia Rutz, AU.D.
• Mark Sacino
• Sassifeet LLC
• Michael Sassine, D.P.M.
• Jill Ann Selbach, PH.D.
• Servcare Therapy Inc
• Lady Michelle Servillas, PT
• Omid M Seylabi, MD
• John F Shaw, M.D.

• Dentist in Lighthouse Point, FL
• Providers in Lighthouse Point, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.