Icom Pompano Beach LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ICOM POMPANO BEACH LLC

Practice address

2323 NE 26TH Ave Ste 108
Pompano Beach, FL 33062-1147

Phone

(954) 507-0799

Fax

(786) 221-4442

NPI assigned

Jan 3, 2024

Last updated

Jan 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tatiana Santiago Herzog

Title

Dentist

Phone

(954) 507-0799

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1427828292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 NE 13TH ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041109",
            "telephone_number": "954-507-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 NE 26TH AVE STE 108",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330621147",
            "telephone_number": "954-507-0799",
            "fax_number": "786-221-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICOM POMPANO BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO HERZOG",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "954-507-0799"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.