Active NPI
Matthew A Freedman, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Sunrise, FL
National Provider Identifier
1386843449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 17966
- Practice address
- 3020 NW 125TH Ave Apt 218
Sunrise, FL 33323-6318 - Phone
- (954) 838-9693
- Fax
- (954) 386-8161
- NPI assigned
- Jul 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 17966 | FL | Primary |
Addresses
Primary practice location
3020 NW 125TH Ave Apt 218
Sunrise, FL 33323-6318
Mailing address
3020 NW 125TH Ave Apt 218
Sunrise, FL 33323-6318
Phone (954) 838-9693
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17966 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1386843449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 NW 125TH AVE APT 218",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333236318",
"telephone_number": "954-838-9693",
"fax_number": "954-386-8161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 NW 125TH AVE APT 218",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333236318",
"telephone_number": "954-838-9693",
"fax_number": "954-386-8161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "MATTHEW",
"middle_name": "A",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-17",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "17966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.