NPIMap

Organization Active NPI

Weston Modern Dentistry, PA

Doing business as Weston Modern Dentistry

  • General Practice Dentistry
  • Weston, FL
National Provider Identifier
1902356389
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WESTON MODERN DENTISTRY, PA
Doing business as
Weston Modern Dentistry
Practice address
280 Indian Trace
Suite a
Weston, FL 33326
Phone
(954) 248-2895
Fax
(954) 248-2896
NPI assigned
Oct 10, 2016
Last updated
Oct 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Dr. Katie McCann
Title
Owner
Phone
(954) 248-2895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

280 Indian Trace
Suite a
Weston, FL 33326

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8500

Other names 1

  • Weston Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

280 Indian Trce
Ste A
Weston, FL 33326
Phone (954) 248-2895

Practitioners & affiliated clinicians

Practitioners 7

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": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1902356389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8500",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 INDIAN TRACE",
            "address_2": "SUITE A",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "33326",
            "telephone_number": "954-248-2895",
            "fax_number": "954-248-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-248-2895",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weston Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.