5TH Avenue Dental PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

5TH AVENUE DENTAL PLLC

Doing business as

5th Avenue Dental

Practice address

1500 N Federal Hwy Ste 280
Ft Lauderdale, FL 33304-5600

Phone

(561) 205-5000

NPI assigned

Jun 30, 2021

Last updated

Jun 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Forrest, DDS

Title

Periodontist/Owner

Phone

(561) 205-5000

Specialties & licenses 1

Addresses

Other names 1

• 5th Avenue Dental Doing business as

Locations

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1609446632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N FEDERAL HWY STE 280",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333045600",
            "telephone_number": "561-205-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N FEDERAL HWY STE 280",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333045600",
            "telephone_number": "561-205-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH AVENUE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PERIODONTIST/OWNER",
        "authorized_official_telephone_number": "561-205-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5th Avenue Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Periodontics in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.