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General NPI Number Information
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NPI Number | 1598614364
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Entity Type | Organization
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Legal Business Name | NOVA SOUTHEASTERN UNIVERSITY, INC
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 2307 W BROWARD BLVD STE 200
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-1420
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Country | US
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Telephone | 954-262-4300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290370
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City | DAVIE
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State | FL
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Zip | 33329-0370
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOHN XANTHOS
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Credential |
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Telephone | 954-262-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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