NPIMap

Organization Active NPI

Florida Dental Studio, PA

  • Dentist
  • Pompano Beach, FL
National Provider Identifier
1760172852
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FLORIDA DENTAL STUDIO, PA
Practice address
2701 NE 14TH Street Cswy Ste 4
Pompano Beach, FL 33062-3535
Phone
(754) 205-4900
Fax
(754) 205-4799
NPI assigned
May 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Dr. Lazaro Gavilla, DDSNPI 1982947651
Title
President
Phone
(305) 586-3767

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2701 NE 14TH Street Cswy Ste 4
Pompano Beach, FL 33062-3535

Mailing address

2701 NE 14TH Street Cswy Ste 4
Pompano Beach, FL 33062-3535
Phone (754) 205-4900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1760172852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 NE 14TH STREET CSWY STE 4",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623535",
            "telephone_number": "754-205-4900",
            "fax_number": "754-205-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NE 14TH STREET CSWY STE 4",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623535",
            "telephone_number": "754-205-4900",
            "fax_number": "754-205-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DENTAL STUDIO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "GAVILLA",
        "authorized_official_first_name": "LAZARO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-586-3767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.