Boca Dental Group PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN14306 Issued in FL

Legal business name

BOCA DENTAL GROUP PA

Practice address

7015 Beracasa Way
Suite 101
Boca Raton, FL 33433

Phone

(561) 338-6411

Fax

(561) 368-9949

NPI assigned

Apr 11, 2007

Last updated

Sep 16, 2013By 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

Brian H Gross, DDSNPI 1720416613

Title

Owner

Phone

(561) 338-6411

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Howard Gross, D.D.S

  • Dentist
  • Boca Raton, FL
  • NPI 1720416613
  NPD (past) Authorized official
• Joshua David Etman, DDS

  • General Practice Dentistry
  • Boca Raton, FL
  • NPI 1750649430
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1659594125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 BERACASA WAY",
            "address_2": "SUITE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33433",
            "telephone_number": "561-338-6411",
            "fax_number": "561-368-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 BERACASA WAY",
            "address_2": "SUITE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33433",
            "telephone_number": "561-338-6411",
            "fax_number": "561-368-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA DENTAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-338-6411",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boca Clinic Imaging Center LLC
• Boca Cove Detox, LLC
• Boca del Mar Pediatric and Adolescent Center PA
• Boca Dental Arts PA
• Boca Dental Care, LLC
• Boca Dental, Inc (Boca Dental)
• Boca Detox Center LLC
• Boca Detox Center LLC
• Boca Developmental Therapy Center, LLC
• Boca Direct MD

• General Practice Dentistry in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.