Individual provider Active NPI

Yosef Chaim Marder, D.M.D.

  • Dentist
  • Pembroke Pines, FL
National Provider Identifier
1386096618
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D20403 Issued in FL
Practice address
302 NW 179TH Ave
Suite # 201
Pembroke Pines, FL 33029-2818
Phone
(954) 374-9215
Fax
(954) 589-0290
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D20403 FL Primary

Addresses

Primary practice location

302 NW 179TH Ave
Suite # 201
Pembroke Pines, FL 33029-2818

Mailing address

538 Coldstream Ave
Toronto, ONTARIO M6B 2K9
CA
Phone (647) 673-7863

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
D20403FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1386096618",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "538 COLDSTREAM AVE",
            "city": "TORONTO",
            "state": "ONTARIO",
            "postal_code": "M6B 2K9",
            "telephone_number": "647-673-7863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 NW 179TH AVE",
            "address_2": "SUITE # 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292818",
            "telephone_number": "954-374-9215",
            "fax_number": "954-589-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDER",
        "first_name": "YOSEF",
        "middle_name": "CHAIM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "D20403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.