Active NPI
Anthony H Bezerra, D.D.S.
- General Practice Dentistry
- Davie, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 546
- Practice address
- 3200 S University Dr
Davie, FL 33328-2018 - Phone
- (954) 262-7369
- Fax
- (954) 262-2689
- NPI assigned
- Feb 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 546 | FL | |
| General Practice Dentistry | 1223G0001X | 546 | FL | Primary |
Addresses
Primary practice location
3200 S University Dr
Davie, FL 33328-2018
Mailing address
PO Box 290370
Ft Lauderdale, FL 33329-0370
Phone (954) 262-4346
Other names 1
- Dr. Antonio Herbete Paz Bezerra
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 546 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nova Southeastern University Inc. | Current | Accepting new patients | |
| Nova Southeastern University, Inc | Current | Accepting new patients | |
| Nova Southeastern University, Inc. | Current | Accepting new patients | |
| Nova Southeastern University, Inc | Past | Accepting new patients | |
| Nova Southeastern University, Inc | Past | Accepting new patients |
Locations
3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200
3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250
650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213
1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000
Organizations & group practices 5
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.
-
- Optometrist
- Ft. Lauderdale, FL
- NPI 1700924511
-
- Clinical Medical Laboratory
- Ft. Lauderdale, FL
- NPI 1770533390
-
- Sports Medicine (Family Medicine) Physician
- Ft. Lauderdale, FL
- NPI 1720126584
-
- Family Medicine Physician
- Davie, FL
- NPI 1447345517
-
- Optometrist
- Davie, FL
- NPI 1588802169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1972800852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 290370",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333290370",
"telephone_number": "954-262-4346",
"fax_number": "954-262-2269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282018",
"telephone_number": "954-262-7369",
"fax_number": "954-262-2689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEZERRA",
"first_name": "ANTHONY",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-11",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "546",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANTONIO",
"last_name": "BEZERRA",
"middle_name": "HERBETE PAZ",
"prefix": "DR.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.