Active NPI
Alan H Bresalier, DDS
- Periodontics
- Weston, FL
National Provider Identifier
1588864110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN9994
- Practice address
- 17190 Royal Palm Blvd
Suite 1
Weston, FL 33326-2379 - Phone
- (954) 384-2220
- NPI assigned
- Jul 22, 2007
- 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 | DN9994 | FL | Primary |
Addresses
Primary practice location
17190 Royal Palm Blvd
Suite 1
Weston, FL 33326-2379
Mailing address
17190 Royal Palm Blvd
Suite 1
Weston, FL 33326-2379
Phone (954) 384-2220
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 |
|---|---|---|---|
| DN9994 | FL | MD | Periodontist |
| 9994 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185062400000",
"number": "1588864110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17190 ROYAL PALM BLVD",
"address_2": "SUITE 1",
"city": "WESTON",
"state": "FL",
"postal_code": "333262379",
"telephone_number": "954-384-2220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17190 ROYAL PALM BLVD",
"address_2": "SUITE 1",
"city": "WESTON",
"state": "FL",
"postal_code": "333262379",
"telephone_number": "954-384-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESALIER",
"first_name": "ALAN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-22",
"last_updated": "2007-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN9994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.