Envision Dental Group

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN 17952

Legal business name

ENVISION DENTAL GROUP

Doing business as

ICP Dental Group

Practice address

3695 W Boynton Beach Blvd
Suite #5
Boynton Beach, FL 33436-4516

Phone

(561) 734-0505

Fax

(561) 734-0506

NPI assigned

Jul 18, 2014

Organization subpart

Yes

Parent organization

VLADIMIR JOVIC DMD PAAs reported in NPPES

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

Authorized official

Name

Vladimir Jovic

Title

President

Phone

(407) 592-8520

Specialties & licenses 1

Addresses

Other names 1

• ICP Dental Group Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Andrade, DMD

  • General Practice Dentistry
  • Boynton Beach, FL
  • NPI 1164152740
  NPD (past)

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1619384955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 GABRIELLA LN",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 W BOYNTON BEACH BLVD",
            "address_2": "SUITE #5",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334364516",
            "telephone_number": "561-734-0505",
            "fax_number": "561-734-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VLADIMIR JOVIC DMD PA",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "JOVIC",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-592-8520"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": "DN 17952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICP Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthodontics in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.