Maximillian Oliver Iurcovich, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18839 Issued in FL

Practice address

2960 Aventura Blvd
Aventura, FL 33180-3103

Phone

(352) 222-2162

NPI assigned

Sep 29, 2009

Last updated

Feb 15, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1366776965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 STRATFORD PL",
            "address_2": "#235",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401525",
            "telephone_number": "352-222-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 AVENTURA BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803103",
            "telephone_number": "352-222-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IURCOVICH",
        "first_name": "MAXIMILLIAN",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-29",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Aventura, FL
• Providers in Aventura, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.