Jason E. Portnof DMD, MD, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN16048 Issued in FL

Legal business name

JASON E. PORTNOF DMD, MD, PA

Practice address

100 SE 15TH Ave
Ft Lauderdale, FL 33301-3985

Phone

(954) 983-1899

Fax

(954) 986-6846

NPI assigned

Feb 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jason E Portnof, DMD, MD

Title

Owner

Phone

(954) 983-1899

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Las Olas Centre for Oral & Maxillofacial Surgery Doing business as

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1699190280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SE 15TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013985",
            "telephone_number": "954-983-1899",
            "fax_number": "954-318-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SE 15TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013985",
            "telephone_number": "954-983-1899",
            "fax_number": "954-986-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON E. PORTNOF DMD, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "PORTNOF",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-983-1899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN16048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "HA085Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Olas Centre for Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriella Jaquez, APRN,PMHNP-BC
• Alicia Francesca Jaramillo, LMHC
• Jorge Jarquin, CSA
• Kristen N Jarrett
• Jarrod S. Wilner, DC, PA
• Jason Evans, PA
• Bernadette A Jasper, LMHC, CAP
• Isabel Jaszewski, MD
• Java Medical Supply LLC
• Javier Garcia Psychiatry & Wellness Center

• Oral and Maxillofacial Surgery (Dentist) in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.