NPIMap

Organization Active NPI

Palm Beach Endodontics, P.a.

  • Endodontics
  • Palm Beach Gardens, FL
National Provider Identifier
1740431980
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN13872 Issued in FL
Legal business name
PALM BEACH ENDODONTICS, P.A.
Practice address
11211 Prosperity Farms Rd
Suite B107
Palm Beach Gardens, FL 33410-3446
Phone
(561) 630-8900
Fax
(561) 630-8909
NPI assigned
Oct 7, 2008
Last updated
Oct 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Authorized official

Name
Dr. Kenneth W. Bradshaw, D.M.D.NPI 1225157977
Title
President
Phone
(561) 630-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN13872 FL Primary
Endodontics 1223E0200X DN16549 FL
Endodontics 1223E0200X DN13841 FL

Addresses

Primary practice location

11211 Prosperity Farms Rd
Suite B107
Palm Beach Gardens, FL 33410-3446

Mailing address

11211 Prosperity Farms Rd
Suite B107
Palm Beach Gardens, FL 33410-3446
Phone (561) 630-8900

National Provider Directory

National Provider Directory

Locations

11211 Prosperity Farms Rd
Ste B107
Palm Beach Gardens, FL 33410
Phone (561) 630-8900

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": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1740431980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD",
            "address_2": "SUITE B107",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103446",
            "telephone_number": "561-630-8900",
            "fax_number": "561-630-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD",
            "address_2": "SUITE B107",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103446",
            "telephone_number": "561-630-8900",
            "fax_number": "561-630-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH ENDODONTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-630-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13872",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN16549",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.