Id III, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ID III, LLC

Practice address

4719 N Ocean Dr
Lauderdale by the Sea, FL 33308-2914

Phone

(954) 933-5937

NPI assigned

Sep 27, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Italo Lozada, DDS

Title

President

Phone

(617) 780-6312

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1881365930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 N OCEAN DR",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333082914",
            "telephone_number": "954-933-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 N OCEAN DR",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333082914",
            "telephone_number": "954-933-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "LOZADA",
        "authorized_official_first_name": "ITALO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-780-6312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Lauderdale by the Sea, FL
• Providers in Lauderdale by the Sea, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.