Individual provider Active NPI

Charles Ernest Nottingham, D.D.S

  • General Practice Dentistry
  • Deerfield Beach, FL
National Provider Identifier
1669568036
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6091 Issued in FL
Practice address
4048 West Hillsboro Blvd
Deerfield Beach, FL 33442
Phone
(954) 429-8506
Fax
(954) 429-9480
NPI assigned
Oct 5, 2006
Last updated
Jul 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6091 FL Primary

Addresses

Primary practice location

4048 West Hillsboro Blvd
Deerfield Beach, FL 33442

Mailing address

4048 West Hillsboro Blvd
Deerfield Beach, FL 33442
Phone (954) 429-8506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6091FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1669568036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 WEST HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "33442",
            "telephone_number": "954-429-8506",
            "fax_number": "954-429-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 WEST HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "33442",
            "telephone_number": "954-429-8506",
            "fax_number": "954-429-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTINGHAM",
        "first_name": "CHARLES",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "6091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.