Individual provider Active NPI

Brad Lewis, D.M.D.

  • General Practice Dentistry
  • Hollywood, FL
National Provider Identifier
1376567685
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10097 Issued in FL
Practice address
900 S Federal Hwy
Hollywood, FL 33020-6051
Phone
(954) 921-0321
Fax
(954) 921-0321
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 DN10097 FL Primary

Addresses

Primary practice location

900 S Federal Hwy
Hollywood, FL 33020-6051

Mailing address

595 NW 158TH Ave
Pembroke Pines, FL 33028-1542
Phone (954) 437-9386

Other practice location 1

1400 NE Miami Gardens Dr
Ste 201
North Miami Beach, FL 33179-4844
Phone (305) 944-4373

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
I20240411001376 FL Practitioner - Dentist 0648599852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakshay Goyal DDS PA CurrentSince Mar 2, 2024 Accepting new patients
Brad Lewis, D.M.D., P.a. Past Accepting new patients

Locations

2901 W Oakland Park Blvd
Ste B21
Oakland Park, FL 33311
Phone (954) 484-4374

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1376567685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 NW 158TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281542",
            "telephone_number": "954-437-9386",
            "fax_number": "954-442-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S FEDERAL HWY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206051",
            "telephone_number": "954-921-0321",
            "fax_number": "954-921-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 NE Miami Gardens Dr",
            "address_2": "STE 201",
            "address_purpose": "LOCATION",
            "city": "North Miami Beach",
            "state": "FL",
            "postal_code": "331794844",
            "country_code": "US",
            "telephone_number": "305-944-4373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.