Organization
NOVA SOUTHEASTERN UNIVERSITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN XANTHOS (EXECUTIVE DIRECTOR)
(954) 262-4100
Entity
Organization
Contact information
Practice address
3060 S. UNIVERSITY DR, FORT LAUDERDALE, FL 33328
(954) 262-4100
Mailing address
PO BOX 290370, DAVIE, FL 33329-0370
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
01/26/2026
Last updated
04/16/2026
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