Individual provider Active NPI

Robert Alan Brody, D.M.D.

  • General Practice Dentistry
  • Pembroke Pines, FL
National Provider Identifier
1295830438
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10219 Issued in FL
Practice address
140 S University Dr
Pembroke Pines, FL 33025-2234
Phone
(954) 431-0004
Fax
(954) 431-6194
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI03008600 NJ
General Practice Dentistry 1223G0001X 063744 NY
General Practice Dentistry 1223G0001X 13934 CT
General Practice Dentistry 1223G0001X DN10219 FL Primary

Addresses

Primary practice location

140 S University Dr
Pembroke Pines, FL 33025-2234

Mailing address

20295 NW 2ND Ave
Suite 202
Miami, FL 33169-2550
Phone (305) 652-6313

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
I20160331000760 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8426355777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13934CTMDGeneral Practice Dentistry
DN10219FLMDGeneral Practice Dentistry
22DI03008600NJMDGeneral Practice Dentistry
063744NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1295830438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20295 NW 2ND AVE",
            "address_2": "SUITE 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331692550",
            "telephone_number": "305-652-6313",
            "fax_number": "305-652-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330252234",
            "telephone_number": "954-431-0004",
            "fax_number": "954-431-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODY",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI03008600",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063744",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "13934",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.