Lake Worth Family Dentistry, PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN14972 Issued in FL

Legal business name

LAKE WORTH FAMILY DENTISTRY, PA

Practice address

6427 Lake Worth Rd Ste 102
Greenacres, FL 33463-2900

Phone

(561) 649-6446

NPI assigned

Sep 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ilya Stein, D.M.D.

Title

President

Phone

(555) 555-5555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222041600000",
    "number": "1689824153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 AVENIDA DEL RIO",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334462444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6427 LAKE WORTH RD STE 102",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334632900",
            "telephone_number": "561-649-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WORTH FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2008-09-22",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "555-555-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070167000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Greenacres, FL
• Providers in Greenacres, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; 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.