Individual provider Active NPI

Gili Litwack

  • General Practice Dentistry
  • Coral Springs, FL
National Provider Identifier
1811517519
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25675 Issued in FL
Practice address
5770 Wiles Rd
Coral Springs, FL 33067-2156
Phone
(954) 255-5166
NPI assigned
Apr 22, 2020
Reactivated
Dec 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN25675 FL Primary

Addresses

Primary practice location

5770 Wiles Rd
Coral Springs, FL 33067-2156

Mailing address

650 S Federal Hwy
Hollywood, FL 33020-5422

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
DN25675FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bespoke Smiles Dentistry, PA CurrentSince Jan 19, 2025 Accepting new patients
Wesley Nelson, DDS PA PastSince Jan 19, 2025 Accepting new patients

Locations

5770 Wiles Rd
Coral Springs, FL 33067
Phone (954) 255-5166

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1811517519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S FEDERAL HWY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330205422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672156",
            "telephone_number": "954-255-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITWACK",
        "first_name": "GILI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "deactivation_date": "2024-11-07",
        "reactivation_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.