Jerry Harris Rosenbaum, D.D.S.,M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

4875 Issued in FL

Practice address

3037 E Commercial Blvd
Fort Lauderdale, FL 33308-4311

Phone

(954) 772-3600

Fax

(954) 772-3663

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659485787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084311",
            "telephone_number": "954-772-3600",
            "fax_number": "954-772-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3037 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084311",
            "telephone_number": "954-772-3600",
            "fax_number": "954-772-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "JERRY",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "4875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Rosauer
• Donald L Rose, PSY.D.
• Sharon Debra Roseman, L.C.S.W.
• Dianne E Rosen, PH.D.
• Matthew Nathan Rosen, MS, LMHC, NCC, PA
• Krista D Rosenberg
• Marcy Joy Rosenberg, M.A.,L.M.H.C.
• Lily T Rosenblatt
• Sheree Berkley Rosenbloom, NP
• Ronald P Rosenheck, D.C.

• 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.