Individual provider Active NPI

Jonathan Chouraqui, D.M.D.

  • General Practice Dentistry
  • Boca Raton, FL
National Provider Identifier
1780024620
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN20472 Issued in FL
Practice address
3401 N Federal Hwy Ste 101
Boca Raton, FL 33431-6005
Phone
(561) 750-6790
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20472 FL Primary

Addresses

Primary practice location

3401 N Federal Hwy Ste 101
Boca Raton, FL 33431-6005

Mailing address

20505 E Country Club Dr Apt 1931
Aventura, FL 33180-3040
Phone (954) 608-1847

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
DN20472FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Myers Dental Arts General Practice CurrentSince Dec 13, 2020 Accepting new patients
Dental Dreams LLC Past Accepting new patients

Locations

12530 New Brittany Blvd
Fort Myers, FL 33907
Phone (239) 936-3030

Organizations & group practices 2

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1780024620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20505 E COUNTRY CLUB DR APT 1931",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803040",
            "telephone_number": "954-608-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N FEDERAL HWY STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316005",
            "telephone_number": "561-750-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOURAQUI",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20472",
            "primary": true
        }
    ],
    "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 Sep 24, 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.