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5TH AVENUE DENTAL PLLC NPI 1609446632


NPI Information

NPI: 1609446632
Provider Name: 5TH AVENUE DENTAL PLLC
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
1500 N FEDERAL HWY STE 280
FT LAUDERDALE, FL
ZIP 33304
Phone: (561) 205-5000
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5TH AVENUE DENTAL PLLC is a periodontics dentist in Ft 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. 5TH AVENUE DENTAL PLLC NPI is 1609446632. 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 280
FT LAUDERDALE, FL
ZIP 33304-600
Phone: (561) 205-5000

The provider's authorized official is Andrew Forrest .
The authorized official title is Periodontist/owner and has the following contact phone number (561) 205-5000.

The enumeration date for this NPI number is 6/30/2021 and was last updated on 6/30/2021.


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
11223P0300XDentistPeriodonticsYes

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: 5/5/2024

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