Jared Evan Lichstrahl, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN14328 Issued in FL

Practice address

2500 N University Dr
Ste#12
Sunrise, FL 33322-3003

Phone

(954) 741-6400

Fax

(954) 741-0105

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 4, 2016 through Apr 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Florida Endodontics

  • Endodontics
  • Sunrise, FL
  • NPI 1871786459
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932219474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N UNIVERSITY DR",
            "address_2": "STE#12",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333223003",
            "telephone_number": "954-741-6400",
            "fax_number": "954-741-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N UNIVERSITY DR",
            "address_2": "STE#12",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333223003",
            "telephone_number": "954-741-6400",
            "fax_number": "954-741-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHSTRAHL",
        "first_name": "JARED",
        "middle_name": "EVAN",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN14328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.