Organization Active NPI

Little Love Pediatric Dentistry and Wellness

  • Pediatric Dentistry
  • St Augustine, FL
National Provider Identifier
1003612730
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
LITTLE LOVE PEDIATRIC DENTISTRY AND WELLNESS
Practice address
50 Silver Forest Dr Ste 108
St Augustine, FL 32092-3836
Phone
(904) 206-8809
NPI assigned
Feb 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amber SunNPI 1588223929
Title
Owner
Phone
(404) 578-5247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

50 Silver Forest Dr Ste 108
St Augustine, FL 32092-3836

Mailing address

628 Southern Oak Dr
Ponte Vedra Beach, FL 32081-8368
Phone (904) 206-8809

National Provider Directory

National Provider Directory

Locations

50 Silver Forest Dr
Ste 108
Saint Augustine, FL 32092
Phone (904) 206-8809

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1003612730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 SOUTHERN OAK DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320818368",
            "telephone_number": "904-206-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SILVER FOREST DR STE 108",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923836",
            "telephone_number": "904-206-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE LOVE PEDIATRIC DENTISTRY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-23",
        "status": "A",
        "authorized_official_last_name": "SUN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-578-5247"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.