Dentastic Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 18328 Issued in FL

Legal business name

DENTASTIC DENTAL CENTER

Practice address

31 SE 24TH Ave Ste 3
Pompano Beach, FL 33062-5347

Phone

(954) 781-4670

NPI assigned

Jul 8, 2008

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Shepard, PA

Title

Manager

Phone

(954) 464-1098

Specialties & licenses 1

Addresses

Tax ID family

Dentastic Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pettissheparddentastic LLC

  dba Dentastic Dental Center

  • Dentist
  • Pompano Beach, FL
  • NPI 1467839522
  NPD tax ID

Locations

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1851554000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SE 24TH AVE STE 3",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330625347",
            "telephone_number": "954-781-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SE 24TH AVE STE 3",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330625347",
            "telephone_number": "954-781-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTASTIC DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-464-1098",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S Dennis, MD
• Matthew Dennison
• Dental Lounge PLLC
• Dental Smile Therapy, PA
• Dental Team of Atlantic
• Dentistry After Hours PLLC (The Smile Mission Fort Lauderdale)
• Raymonde Deravil
• Victor Samuel Derosa
• Meghan Desanctis, MASTERS IN EDUCATION
• Philip S Desenze

• General Practice Dentistry in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.