Northstar Dental, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN9275 Issued in FL

Legal business name

NORTHSTAR DENTAL, INC.

Practice address

1225 N Military TRL
West Palm Beach, FL 33409-6059

Phone

(561) 721-9992

Fax

(561) 686-8948

NPI assigned

Mar 30, 2007

Last updated

Aug 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ralph Jimenez

Title

Owner

Phone

(561) 721-9992

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1801916861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 N MILITARY TRL",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096059",
            "telephone_number": "561-721-9992",
            "fax_number": "561-686-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N MILITARY TRL",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096059",
            "telephone_number": "561-721-9992",
            "fax_number": "561-686-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-721-9992",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• General Practice Dentistry in Florida

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