Individual provider Active NPI

Elliott Nathan Katz, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bradenton, FL
National Provider Identifier
1760725063
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN21771 Issued in FL
Practice address
3611 1St St E Ste 530
Bradenton, FL 34208-4423
Phone
(941) 746-7460
NPI assigned
Apr 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X DN21771 FL Primary

Addresses

Primary practice location

3611 1St St E Ste 530
Bradenton, FL 34208-4423

Mailing address

424 45TH Ave NE
St Petersburg, FL 33703-5028
Phone (419) 290-1850

Other practice location 1

3806 W Linebaugh Ave
Tampa, FL 33618-8702
Phone (813) 960-0917

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN21771FLMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alan D. Shoopak D.M.D. ,P.a. Orthodontics and Dentofacial Orthopedics PastSince Nov 27, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1760725063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 45TH AVE NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337035028",
            "telephone_number": "419-290-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 1ST ST E STE 530",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342084423",
            "telephone_number": "941-746-7460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3806 W Linebaugh Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336188702",
            "country_code": "US",
            "telephone_number": "813-960-0917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATZ",
        "first_name": "ELLIOTT",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN21771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.