NPIMap

Organization Active NPI

Citrus Ridge Dental Center, PA

  • Dentist
  • Clermont, FL
National Provider Identifier
1023006426
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CITRUS RIDGE DENTAL CENTER, PA
Practice address
194 N Highway 27
Suite F
Clermont, FL 34711-2448
Phone
(352) 243-0018
Fax
(352) 243-6700
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kristin C Kalwara, D.D.S.NPI 1427160530
Title
President
Phone
(352) 243-0018

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X FL Primary

Addresses

Primary practice location

194 N Highway 27
Suite F
Clermont, FL 34711-2448

Mailing address

194 N Highway 27
Suite F
Clermont, FL 34711-2448
Phone (352) 243-0018

National Provider Directory

National Provider Directory

Locations

194 N US Highway 27
Ste F
Clermont, FL 34711
Phone (352) 243-0018

Practitioners & affiliated clinicians

Practitioners 2

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": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023006426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 N HIGHWAY 27",
            "address_2": "SUITE F",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112448",
            "telephone_number": "352-243-0018",
            "fax_number": "352-243-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 N HIGHWAY 27",
            "address_2": "SUITE F",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112448",
            "telephone_number": "352-243-0018",
            "fax_number": "352-243-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS RIDGE DENTAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KALWARA",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-243-0018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.