Main Street Children'S Dentistry and Orthodontics of South Broward, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF SOUTH BROWARD, PA

Practice address

9900 Stirling Rd Ste 100
Hollywood, FL 33024-8043

Phone

(954) 432-8707

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Melody Parrish

Title

Director of Operations

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Other names 1

• Main Street Orthodontics of South Broward Doing business as

Tax ID family

Main Street Children'S Dentistry and Orthodontics of South Broward PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Main Street Children'S Dentistry and Orthodontics of South Broward, PA

  • Pediatric Dentistry
  • Cooper City, FL
  • NPI 1891807160
  NPD tax ID

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407951833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 STIRLING RD STE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248043",
            "telephone_number": "954-432-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 STIRLING RD STE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248043",
            "telephone_number": "954-432-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF SOUTH BROWARD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARRISH",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "305-274-2499",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Orthodontics of South Broward",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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.