Serge Moldavsky, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN29301 Issued in FL

Practice address

560 N Washington Blvd Ste B
Sarasota, FL 34236-4253

Phone

(973) 787-4029

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• 3DMD Family Dentistry LLC

  • Dentist
  • Sarasota, FL
  • NPI 1386450021
  NPD Authorized official
• Serge Moldavsky DMD, PC

  • General Practice Dentistry
  • Morristown, NJ
  • NPI 1194934570
  NPD (past) Authorized official

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1396894630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14653 NEWTONMORE LN",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025641",
            "telephone_number": "973-787-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N WASHINGTON BLVD STE B",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342364253",
            "telephone_number": "973-787-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDAVSKY",
        "first_name": "SERGE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062467-01",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI19744",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sukanya Mohan, DO
• David Gilbert Mohr, D.O.
• Lynn Mohrmann, PT
• Daphnee Moise-Johnson, MD
• Jhoanne Mojica
• Vickie Moles, ARNP
• Tesyl Molina, LCSW
• Dennis Molinari, MD
• Andrea Moline, OT
• Kay Moliner Garcia, OTR

• General Practice Dentistry in Sarasota, FL
• Providers in Sarasota, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.