Individual provider Active NPI

Nicholas Perez, D.M.D

  • General Practice Dentistry
  • Palm Beach Gardens, FL
National Provider Identifier
1366127078
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27897 Issued in FL
Practice address
2560 Rca Blvd Ste 101
Palm Beach Gardens, FL 33410-3335
Phone
(561) 622-5600
NPI assigned
Jun 20, 2023
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27897 FL Primary

Addresses

Primary practice location

2560 Rca Blvd Ste 101
Palm Beach Gardens, FL 33410-3335

Mailing address

7896 Sonoma Springs Cir Apt 204
Lake Worth, FL 33463-7933
Phone (561) 901-0532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27897FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel J. Holcroft, DMD.PA General Practice PastSince Jun 25, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1366127078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7896 SONOMA SPRINGS CIR APT 204",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334637933",
            "telephone_number": "561-901-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 RCA BLVD STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103335",
            "telephone_number": "561-622-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "NICHOLAS",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "27897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.