Active NPI
Mark Forrest, DMD
- Periodontics
- Pembroke Pines, FL
National Provider Identifier
1457423360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 5906
- Practice address
- 601 N Flamingo Rd
Suite 318
Pembroke Pines, FL 33028-1015 - Phone
- (954) 435-0100
- Fax
- (954) 430-8900
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 5906 | FL | Primary |
Addresses
Primary practice location
601 N Flamingo Rd
Suite 318
Pembroke Pines, FL 33028-1015
Mailing address
601 N Flamingo Rd
Suite 318
Pembroke Pines, FL 33028-1015
Phone (954) 435-0100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5906 | FL | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Forrest D.M.D. P.a. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Pembroke Pines, FL
- NPI 1992187330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457423360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 N FLAMINGO RD",
"address_2": "SUITE 318",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330281015",
"telephone_number": "954-435-0100",
"fax_number": "954-430-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 N FLAMINGO RD",
"address_2": "SUITE 318",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330281015",
"telephone_number": "954-435-0100",
"fax_number": "954-430-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORREST",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "5906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.