Individual provider Active NPI

Ernest Stephen Orphanos, DDS

  • Periodontics
  • Boca Raton, FL
National Provider Identifier
1811168586
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN0013699 Issued in FL
Practice address
9291 Glades Rd
Suite 301
Boca Raton, FL 33434-3959
Phone
(561) 477-7171
Fax
(561) 477-7577
NPI assigned
Mar 20, 2008
Last updated
Mar 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN0013699 FL Primary

Addresses

Primary practice location

9291 Glades Rd
Suite 301
Boca Raton, FL 33434-3959

Mailing address

9291 Glades Rd
Suite 301
Boca Raton, FL 33434-3959
Phone (561) 477-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170112000883 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2062794753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0013699FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Smile Orthodontics of Pembroke Pines, LLC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1811168586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9291 GLADES RD",
            "address_2": "SUITE 301",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343959",
            "telephone_number": "561-477-7171",
            "fax_number": "561-477-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9291 GLADES RD",
            "address_2": "SUITE 301",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343959",
            "telephone_number": "561-477-7171",
            "fax_number": "561-477-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORPHANOS",
        "first_name": "ERNEST",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN0013699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.