Pembroke Pines Dental Health Center, PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN 16213 Issued in FL

Legal business name

PEMBROKE PINES DENTAL HEALTH CENTER, PA

Practice address

1851 NW 125TH Ave
#170
Pembroke Pines, FL 33028-2596

Phone

(954) 437-2040

Fax

(954) 437-4573

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Victor Sootin, D.D.S.

Title

Owner

Phone

(954) 437-2040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679620942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 NW 125 AVE",
            "address_2": "#170",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33028",
            "telephone_number": "954-437-2040",
            "fax_number": "954-437-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 NW 125TH AVE",
            "address_2": "#170",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282596",
            "telephone_number": "954-437-2040",
            "fax_number": "954-437-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE PINES DENTAL HEALTH CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOOTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-437-2040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN 16213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pembroke Pavilion Psychiatric Associates, Inc
• Pembroke Pines Accident & Injury Center, Inc.
• Pembroke Pines Ambulatory Surgery Center, LLC
• Pembroke Pines Artificial Kidney Center Inc
• Pembroke Pines Community Health Center Inc
• Pembroke Pines Family Dental Center
• Pembroke Pines Medical Center
• Pembroke Pines MRI Inc
• Pembroke Pines Pediatric Dentistry
• Pembroke Pines Therapy Center LLC

• Periodontics in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.