Individual provider Active NPI

Luis Fernando Saucedo, DDS

  • General Practice Dentistry
  • Fort Lauderdale, FL
National Provider Identifier
1821283516
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18093 Issued in FL
Practice address
1608 E Commercial Blvd
Fort Lauderdale, FL 33322
Phone
(954) 489-1345
Fax
(954) 489-1052
NPI assigned
Sep 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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 DN18093 FL Primary

Addresses

Primary practice location

1608 E Commercial Blvd
Fort Lauderdale, FL 33322

Mailing address

1608 E Commercial Blvd
Fort Lauderdale, FL 33334-5719
Phone (954) 489-1345

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
DN18093FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1821283516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333345719",
            "telephone_number": "954-489-1345",
            "fax_number": "954-489-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33322",
            "telephone_number": "954-489-1345",
            "fax_number": "954-489-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCEDO",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.