Wilton Manors Dental

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

DN18173 Issued in FL

Legal business name

WILTON MANORS DENTAL

Practice address

2517 NE 9TH Ave
Wilton Manors, FL 33305-1284

Phone

(954) 564-4746

NPI assigned

Jun 23, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Alexandra Gutersohn-McCoy

Title

Office Manager

Phone

(954) 564-4746

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Norman Young Young Sr., DMD

  • Dentist
  • Wilton Manors, FL
  • NPI 1245448877
  NPD (past)

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1972918555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 NE 9TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 NE 9TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051284",
            "telephone_number": "954-564-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILTON MANORS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "GUTERSOHN-MCCOY",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-564-4746",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "DN18173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Kimesha Williams, REGISTERED NURSE
• Lynn Susan Williams, RPH
• Shantigra Williams, LMHC, CTP
• Williamsburg Landing Operator, LLC
• Jessica Wilson-McCoy
• Wilton Manors Healthcare & Rehabilitation Center LLC
• Wilton Manors Urgent Care & Diagnostic
• Emily L Woods, LMHC
• Darlene S. Wooldridge, P.T.
• Casey Woolley, M.S.W.

• Preferred Provider Organization in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.