Organization Active NPI

Amazing Dental L.L.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hollywood, FL
National Provider Identifier
1497126817
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
AMAZING DENTAL L.L.C.
Practice address
5740 Hollywood Blvd
Suite# 400
Hollywood, FL 33021-6357
Phone
(954) 544-2814
Fax
(954) 544-2913
NPI assigned
Oct 12, 2015
Last updated
Oct 12, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
AMAZING DENTAL L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Authorized official

Name
Mary Cecilia Crosby, D.D.S.
Title
President
Phone
(954) 544-2814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

5740 Hollywood Blvd
Suite# 400
Hollywood, FL 33021-6357

Mailing address

5740 Hollywood Blvd
Suite# 400
Hollywood, FL 33021-6357
Phone (954) 544-2814

National Provider Directory

National Provider Directory
Part of
Amazing Dental LLC

Locations

5740 Hollywood Blvd
Ste 400
Hollywood, FL 33021
Phone (954) 544-2814

Practitioners & affiliated clinicians

Practitioners 1

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": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1497126817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5740 HOLLYWOOD BLVD",
            "address_2": "SUITE# 400",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216357",
            "telephone_number": "954-544-2814",
            "fax_number": "954-544-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 HOLLYWOOD BLVD",
            "address_2": "SUITE# 400",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216357",
            "telephone_number": "954-544-2814",
            "fax_number": "954-544-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING DENTAL L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMAZING DENTAL L.L.C.",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-544-2814",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.