Organization Active NPI

Stephen H Wander, DDS, PA

  • Pediatric Dentistry
  • Pembroke Pines, FL
National Provider Identifier
1396840252
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
4723 Issued in FL
Legal business name
STEPHEN H WANDER, DDS, PA
Practice address
12301 Taft St
#300
Pembroke Pines, FL 33026-4387
Phone
(954) 962-8311
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen H Wander, DDSNPI 1487759338
Title
President
Phone
(954) 962-8311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 4723 FL Primary

Addresses

Primary practice location

12301 Taft St
#300
Pembroke Pines, FL 33026-4387

Mailing address

12301 Taft St
#300
Pembroke Pines, FL 33026-4387
Phone (954) 962-8311

Other identifiers 1

IdentifierTypeStateIssuer
4723OtherFLLICENSE

National Provider Directory

National Provider Directory

Locations

12301 Taft St
Ste 300
Pembroke Pines, FL 33026
Phone (953) 962-8311

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396840252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 TAFT ST",
            "address_2": "#300",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264387",
            "telephone_number": "954-962-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 TAFT ST",
            "address_2": "#300",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264387",
            "telephone_number": "954-962-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN H WANDER, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANDER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-962-8311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "4723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4723",
            "state": "FL"
        }
    ],
    "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 Aug 22, 2020; 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.