Broward County Dental Surgery PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN5272 Issued in FL

Legal business name

BROWARD COUNTY DENTAL SURGERY PA

Practice address

5181 NE 19 Ave
Ft Lauderdale, FL 33308

Phone

(954) 562-9610

Fax

(954) 772-2569

NPI assigned

Aug 1, 2012

Last updated

Dec 17, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

BROWARD COUNTY DENTAL SURGERY PAAs reported in NPPES

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

Authorized official

Name

Dr. John R Clarke, DMDNPI 1972676989

Title

President Broward County Dental Sur

Phone

(954) 562-9610

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Broward County Dental Surgery PA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Rushford Clarke

  • Oral and Maxillofacial Surgery (Dentist)
  • Plantation, FL
  • NPI 1972676989
  NPD (past) Authorized official

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1861748402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11223",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33339",
            "telephone_number": "954-562-9610",
            "fax_number": "954-772-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5181 NE 19 AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-562-9610",
            "fax_number": "954-772-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD COUNTY DENTAL SURGERY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROWARD COUNTY DENTAL SURGERY PA",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT BROWARD COUNTY DENTAL SUR",
        "authorized_official_telephone_number": "954-562-9610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN5272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070653100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broward Chiropractic Center Inc.
• Broward Community Center Inc
• Broward County (Broward Addiction Recovery Center)
• Broward County (Broward Addiction Recovery Division)
• Broward County Community Development Corp., Inc. (Broward Housing Solutions)
• Broward County Department of Health
• Broward County Department of Health
• Broward County Department of Health
• Broward County Department of Health
• Broward County Department of Health

• Oral and Maxillofacial Surgery (Dentist) in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.