NPIMap

Organization Active NPI

Davie Modern Dentistry, PA

Doing business as Davie Modern Dentistry

  • General Practice Dentistry
  • Davie, FL
National Provider Identifier
1437519998
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DAVIE MODERN DENTISTRY, PA
Doing business as
Davie Modern Dentistry
Practice address
5796 S University Dr
102
Davie, FL 33328
Phone
(954) 248-2742
Fax
(954) 251-4141
NPI assigned
Feb 26, 2016
Last updated
Feb 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Authorized official

Name
Dr. Katie L McCann, DDS
Title
Owner,Dentist
Phone
(954) 248-2742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

5796 S University Dr
102
Davie, FL 33328

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Davie Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

5796 S University Dr
Ste 102
Davie, FL 33328
Phone (954) 248-2742

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1437519998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5796 S UNIVERSITY DR",
            "address_2": "102",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "33328",
            "telephone_number": "954-248-2742",
            "fax_number": "954-251-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIE MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER,DENTIST",
        "authorized_official_telephone_number": "954-248-2742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davie Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.