Individual provider Active NPI

Suncica Martinasevic, D.M.D.

  • Dentist
  • Fort Lauderdale, FL
National Provider Identifier
1720333636
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19844 Issued in FL
Practice address
1209 W Broward Blvd
Ft Lauderdale, FL 33312-1640
Phone
(954) 763-3358
NPI assigned
Jul 17, 2012
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19844 FL Primary

Addresses

Primary practice location

1209 W Broward Blvd
Ft Lauderdale, FL 33312-1640

Mailing address

501 NE 5TH Ter Apt 530
Fort Lauderdale, FL 33301-1798
Phone (954) 294-2111

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
DN19844FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thedenteast, PLLC Current Accepting new patients
Michael Barnard DDS PA Dentist PastSince May 16, 2021 Accepting new patients
Indian Trace Dental Associates,P.a. PastSince May 16, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1720333636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 NE 5TH TER APT 530",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011798",
            "telephone_number": "954-294-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W BROWARD BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121640",
            "telephone_number": "954-763-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINASEVIC",
        "first_name": "SUNCICA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.