Southeastern Dental Associates II

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN15761 Issued in FL

Legal business name

SOUTHEASTERN DENTAL ASSOCIATES II

Practice address

210 Jupiter Lakes Blvd
Building 5000 Suite 204
Jupiter, FL 33458

Phone

(561) 575-7720

Fax

(561) 575-7751

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alexander I Wang, DMD

Title

Co Owner

Phone

(561) 575-7720

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447325113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "BUILDING 5000 SUITE 204",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-575-7720",
            "fax_number": "561-575-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "BUILDING 5000 SUITE 204",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-575-7720",
            "fax_number": "561-575-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DENTAL ASSOCIATES II",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "561-575-7720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN15761",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN14485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Florida Medicine LLC
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• South Florida Speech and Swallow
• South Florida Urology Institute LLC
• Southeastern Internal Medicine LLC
• Southern Home Care Services, Inc.
• Debora Souza, LMT
• Michael Robert Sovis, NP
• Caroline Poryles Soyka, D.O.

• Periodontics in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Periodontics in Florida

• 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.