NPIMap

Organization Active NPI

Palm Beach Periodontics, P.C.

  • Periodontics
  • West Palm Beach, FL
National Provider Identifier
1831236223
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN15413 Issued in FL
Legal business name
PALM BEACH PERIODONTICS, P.C.
Practice address
1840 Forest Hill Blvd
Suite #202
West Palm Beach, FL 33406-6063
Phone
(561) 967-0476
Fax
(561) 967-9138
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Russell Alan Gornstein, D.D.S., M.S.NPI 1558427971
Title
Owner
Phone
(561) 967-0476

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DN15413 FL Primary

Addresses

Primary practice location

1840 Forest Hill Blvd
Suite #202
West Palm Beach, FL 33406-6063

Mailing address

1840 Forest Hill Blvd
Suite #202
West Palm Beach, FL 33406-6063
Phone (561) 967-0476

National Provider Directory

National Provider Directory

Locations

1840 Forest Hill Blvd
Ste 202
West Palm Beach, FL 33406
Phone (561) 967-0476

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831236223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 FOREST HILL BLVD",
            "address_2": "SUITE #202",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066063",
            "telephone_number": "561-967-0476",
            "fax_number": "561-967-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 FOREST HILL BLVD",
            "address_2": "SUITE #202",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066063",
            "telephone_number": "561-967-0476",
            "fax_number": "561-967-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH PERIODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORNSTEIN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-967-0476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN15413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.