Individual provider Active NPI

Andrea Lewis-McKenzie, DMD

  • Dentist
  • Plantation, FL
National Provider Identifier
1972910537
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20754 Issued in FL
Practice address
7744 Peters Rd
Plantation, FL 33324-4004
Phone
(954) 951-0181
NPI assigned
Jul 16, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20754 FL Primary

Addresses

Primary practice location

7744 Peters Rd
Plantation, FL 33324-4004

Mailing address

PO Box 770112
Coral Springs, FL 33077-0112
Phone (954) 951-0181

Other practice location 1

2717 E Oakland Park Blvd
Fort Lauderdale, FL 33306-1664
Phone (954) 566-7479

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
I20160901002238 FL Order and Referring Only - DentistPractitioner - Dentist 3274829130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN20754FLMDDentist

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972910537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770112",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330770112",
            "telephone_number": "954-951-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7744 PETERS RD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333244004",
            "telephone_number": "954-951-0181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2717 E Oakland Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333061664",
            "country_code": "US",
            "telephone_number": "954-566-7479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS-MCKENZIE",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.