Individual provider Active NPI

Renee F. Litvak, D.D.S.

  • Endodontics
  • Fort Lauderdale, FL
National Provider Identifier
1912104407
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN21142 Issued in FL
Practice address
3001 E Commercial Blvd
Fort Lauderdale, FL 33308
Phone
(954) 491-7100
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 050403 NY
Endodontics 1223E0200X DN21142 FL Primary

Addresses

Primary practice location

3001 E Commercial Blvd
Fort Lauderdale, FL 33308

Mailing address

5899 NW 25TH CT
Boca Raton, FL 33496
Phone (917) 359-9781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314000098 FL Order and Referring Only - DentistPractitioner - Dentist 4880990167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN21142FLMDEndodontist
050403NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1912104407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5899 NW 25TH CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33496",
            "telephone_number": "917-359-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-491-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITVAK",
        "first_name": "RENEE",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "050403",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN21142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.