NPIMap

Organization Active NPI

Nova Southeastern University, Inc.

  • Pediatric Dentistry
  • Hollywood, FL
National Provider Identifier
1548406812
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NOVA SOUTHEASTERN UNIVERSITY, INC.
Practice address
3501 Johnson Street 2ND Floor Suite 200
Joe Dimaggio Children's Hospital Medical Office Centre
Hollywood, FL 33021-5421
Phone
(954) 262-2187
Fax
(954) 262-2910
NPI assigned
Dec 17, 2008
Last updated
Jul 7, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
NOVA SOUTHEASTERN UNIVERSITY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Robert S. Oller, D.O.
Title
Clinical Operations
Phone
(954) 262-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

3501 Johnson Street 2ND Floor Suite 200
Joe Dimaggio Children's Hospital Medical Office Centre
Hollywood, FL 33021-5421

Mailing address

3200 S University Drive
Sanford L. Ziff BLDG. 3Rd Floor, Room 4364-D
Ft. Lauderdale, FL 33328-2018
Phone (954) 262-4343

National Provider Directory

National Provider Directory
Tax ID family
Nova Southeastern Univ38 organizations share this tax ID, including this one
Part of
Nova Southeastern Univ

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1548406812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DRIVE",
            "address_2": "SANFORD L. ZIFF BLDG. 3RD FLOOR, ROOM 4364-D",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4343",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON STREET 2ND FLOOR SUITE 200",
            "address_2": "JOE DIMAGGIO CHILDREN'S HOSPITAL MEDICAL OFFICE CENTRE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-262-2187",
            "fax_number": "954-262-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA SOUTHEASTERN UNIVERSITY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "enumeration_date": "2008-12-17",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "OLLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "954-262-4343",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "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 Jul 7, 2011; 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.