Lifestyle Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

DN18993 Issued in FL

Legal business name

LIFESTYLE DENTAL GROUP

Practice address

3401 N Federal Hwy
101
Boca Raton, FL 33431-6046

Phone

(561) 750-6790

Fax

(561) 750-0535

NPI assigned

Aug 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Tatiana Santiago-Herzog, DDS

Title

Dentist

Phone

(561) 750-6790

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1417356973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N FEDERAL HWY",
            "address_2": "101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316046",
            "telephone_number": "561-750-6790",
            "fax_number": "561-750-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N FEDERAL HWY",
            "address_2": "101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316046",
            "telephone_number": "561-750-6790",
            "fax_number": "561-750-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO-HERZOG",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "561-750-6790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Quality Rehabilitative Services Inc.
• Lifegaines Medical and Aesthetics
• Lifelab MD LLC
• Lifespan Health Services LLC
• Lifestore Medical Supply, LLC
• Lifestyle Therapeutics LLC
• Lifetime Health Services Inc
• Ruth B Light, PT
• Lighthouse Medical Supply LLC
• Lighthouse Orthopaedic Associates

• Dentist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.