Organization Active NPI

Gerard Wasselle DMD LLC

  • General Practice Dentistry
  • Ft Lauderdale, FL
National Provider Identifier
1619507779
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GERARD WASSELLE DMD LLC
Practice address
2480 E Commercial Blvd, Suite 2
Ft Lauderdale, FL 33308-3330
Phone
(954) 928-1666
Fax
(954) 928-1895
NPI assigned
Jan 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Authorized official

Name
Susan Wasselle
Title
Office Manager
Phone
(907) 223-1013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2480 E Commercial Blvd, Suite 2
Ft Lauderdale, FL 33308-3330

Mailing address

2440 E Commercial Blvd
Ft Lauderdale, FL 33308-4027
Phone (954) 771-1901

National Provider Directory

National Provider Directory

Locations

2480 E Commercial Blvd
Ste 2
Ft Lauderdale, FL 33308
Phone (954) 351-1100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1619507779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 E COMMERCIAL BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084027",
            "telephone_number": "954-771-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 E COMMERCIAL BLVD, SUITE 2",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083330",
            "telephone_number": "954-928-1666",
            "fax_number": "954-928-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERARD WASSELLE DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "WASSELLE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "907-223-1013"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.