1500 DENTAL LLC NPI 1073002259

NPI Information

NPI: 1073002259
Provider Name: 1500 DENTAL LLC
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
1500 N FEDERAL HWY STE 250
FORT LAUDERDALE, FL
ZIP 33304
Phone: (954) 715-1000
Get Directions

1500 DENTAL LLC is a periodontics dentist in Fort Lauderdale, FL. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. 1500 DENTAL LLC NPI is 1073002259. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1500 N FEDERAL HWY STE 250
FORT LAUDERDALE, FL
ZIP 33304-603
Phone: (954) 715-1000
Fax: (954) 372-1000

The provider's authorized official is Nekelda A Weiss .
The authorized official title is Insurance & Credentialing Coordinat and has the following contact phone number (954) 715-1000.

The enumeration date for this NPI number is 5/3/2018 and was last updated on 5/3/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		DN14284	FLORIDA	No
2	1223P0300X	Dentist	Periodontics	DN16336	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1407978679	OTHER	FLORIDA	NPI
2	1043392111	OTHER	FLORIDA	NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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