NPIMap

Organization Active NPI

South Florida Center for Periodontics & Implant Dentistry

  • Periodontics
  • Boca Raton, FL
National Provider Identifier
1710015300
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN11979 Issued in FL
Legal business name
SOUTH FLORIDA CENTER FOR PERIODONTICS & IMPLANT DENTISTRY
Practice address
3020 N Military Trail
Suite 200
Boca Raton, FL 33431
Phone
(561) 912-9993
Fax
(561) 912-9883
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Authorized official

Name
Mr. Fredrick Norkin
Title
Vice-President
Phone
(561) 912-9993

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DN11979 FL Primary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DN14637
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DN21795 FL

Addresses

Primary practice location

3020 N Military Trail
Suite 200
Boca Raton, FL 33431

Mailing address

3020 N Military Trail
Suite 200
Boca Raton, FL 33431
Phone (561) 912-9993

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555977600000",
    "number": "1710015300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 N MILITARY TRAIL",
            "address_2": "SUITE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33431",
            "telephone_number": "561-912-9993",
            "fax_number": "561-912-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 N MILITARY TRAIL",
            "address_2": "SUITE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33431",
            "telephone_number": "561-912-9993",
            "fax_number": "561-912-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA CENTER FOR PERIODONTICS & IMPLANT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2019-04-23",
        "status": "A",
        "authorized_official_last_name": "NORKIN",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "561-912-9993",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN11979",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": "DN14637",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN21795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.