NPIMap

Organization Active NPI

Pediatric and Orthodontic Dental Centers of Broward

Doing business as Pediatric Dental Centers of Broward

  • Pediatric Dentistry
  • Coral Springs, FL
National Provider Identifier
1902027683
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN17284 Issued in FL
Legal business name
PEDIATRIC AND ORTHODONTIC DENTAL CENTERS OF BROWARD
Doing business as
Pediatric Dental Centers of Broward
Practice address
8351 W Atlantic Blvd
Coral Springs, FL 33071-7454
Phone
(954) 341-0002
NPI assigned
May 1, 2007
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Enrique Acosta, DDSNPI 1790708865
Title
Pediatric Dentist
Phone
(954) 341-0002

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
Pediatric Dentistry 1223P0221X DN17284 FL Primary

Addresses

Primary practice location

8351 W Atlantic Blvd
Coral Springs, FL 33071-7454

Mailing address

8351 W Atlantic Blvd
Coral Springs, FL 33071-7454
Phone (954) 341-0002

Other identifiers 3

IdentifierTypeStateIssuer
076721200MedicaidFL
076110900MedicaidFL
076240700MedicaidFL

Other names 1

  • Pediatric Dental Centers of Broward Doing business as

National Provider Directory

National Provider Directory

Locations

8351 W Atlantic Blvd
Pompano Beach, FL 33071
Phone (954) 341-0002

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1902027683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8351 W ATLANTIC BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330717454",
            "telephone_number": "954-341-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8351 W ATLANTIC BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330717454",
            "telephone_number": "954-341-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ORTHODONTIC DENTAL CENTERS OF BROWARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "954-341-0002",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076721200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076110900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076240700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Centers of Broward",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.