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DR. MICHAEL JONATHAN THEISS DDS NPI 1235628991


NPI Information

NPI: 1235628991
Provider Name: DR. MICHAEL JONATHAN THEISS, DDS
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
17901 NW 5TH STREET
SUITE # 101
PEMBROKE PINES, FL
ZIP 33029
Phone: (954) 437-2222
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DR. Michael Jonathan Theiss, DDS is a student in an organized health care education training program in Pembroke Pines, FL with 6 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Michael Jonathan Theiss, DDS NPI is 1235628991. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: STATE UN OF NY, STONY BROOK SCHOOL OF DENTAL MED
Graduation Year:2018

The provider's business location address is:

17901 NW 5TH STREET
SUITE # 101
PEMBROKE PINES, FL
ZIP 33029
Phone: (954) 437-2222
Fax: (954) 437-2244

The NPI 1235628991 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/8/2018 and was last updated on 8/22/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery0442000331VIRGINIANo
2204E00000XOral & Maxillofacial Surgery0442000331VIRGINIANo
3390200000XStudent in an Organized Health Care Education/Training ProgramYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.