Active NPI
Jeffrey Mabry, DMD
- General Practice Dentistry
- West Palm Beach, FL
National Provider Identifier
1790807741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN 17774
- Practice address
- 4623 Forest Hill Blvd
Suite 114
West Palm Beach, FL 33415-7469 - Phone
- (561) 965-7000
- Fax
- (561) 965-8117
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN 17774 | FL | Primary |
Addresses
Primary practice location
4623 Forest Hill Blvd
Suite 114
West Palm Beach, FL 33415-7469
Mailing address
3114 Enclave Way
Lauderhill, FL 33319-5146
Phone (321) 505-3895
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN 17774 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Winning Smile | General Practice | Past | 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": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790807741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3114 ENCLAVE WAY",
"city": "LAUDERHILL",
"state": "FL",
"postal_code": "333195146",
"telephone_number": "321-505-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4623 FOREST HILL BLVD",
"address_2": "SUITE 114",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334157469",
"telephone_number": "561-965-7000",
"fax_number": "561-965-8117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABRY",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN 17774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.