Individual provider Active NPI

Raynald Michel, D.D.S

  • Dentist
  • Fort Lauderdale, FL
National Provider Identifier
1376859306
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19473 Issued in FL
Practice address
3051 N Federal Hwy
Suite 1
Fort Lauderdale, FL 33306-1456
Phone
(954) 573-2500
NPI assigned
Aug 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19473 FL Primary

Addresses

Primary practice location

3051 N Federal Hwy
Suite 1
Fort Lauderdale, FL 33306-1456

Mailing address

3051 N Federal Hwy
Fort Lauderdale, FL 33306-1456
Phone (954) 563-5800

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
I20151222000625 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8527369255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN19473FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Contemporale Inc Dentist PastSince Sep 1, 2020 Accepting new patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist Past Accepting new patients

Organizations & group practices 3

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": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1376859306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061456",
            "telephone_number": "954-563-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 N FEDERAL HWY",
            "address_2": "SUITE 1",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061456",
            "telephone_number": "954-573-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "RAYNALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.