Active NPI
Charles Keith Raynor, DMD
- General Practice Dentistry
- Miramar, FL
National Provider Identifier
1821298746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN0014927
- Practice address
- 3000 SW 148TH Ave
Miramar, FL 33027-4169 - Phone
- (954) 450-4533
- Fax
- (954) 450-4834
- NPI assigned
- Jul 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | DN0014927 | FL | Primary |
Addresses
Primary practice location
3000 SW 148TH Ave
Miramar, FL 33027-4169
Mailing address
3000 SW 148TH Ave
Miramar, FL 33027-4169
Phone (954) 450-4533
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 |
|---|---|---|---|
| DN0014927 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1821298746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 SW 148TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274169",
"telephone_number": "954-450-4533",
"fax_number": "954-450-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 SW 148TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274169",
"telephone_number": "954-450-4533",
"fax_number": "954-450-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYNOR",
"first_name": "CHARLES",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-19",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN0014927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.